MEDICARE: CHRISTINA ELAINE HARRIS MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	C5104608	CA
2	207R00000X	Internal Medicine Physician	C56051	CA

General Provider Information

NPI Number	:	1073553962
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTINA ELAINE HARRIS MD

Provider Business Mailing Address
First Line	:	4140 W 190TH ST
Second Line	:
City	:	TORRANCE
State	:	CA
Zip	:	90504-5513
Country	:	US
Telephone Number	:	310-423-6321
Fax Number	:

Provider Business Practice Location Address
First Line	:	8723 ALDEN DR
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90048-3692
Country	:	US
Telephone Number	:	310-423-6321
Fax Number	:	310-423-0420

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/08/2006
Last Update Date	:	12/19/2022

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