Provider Demographics
NPI:1538271556
Name:HARRIS & BATRA CARDIOLOGY MEDICAL GROUP, INC.
Entity type:Organization
Organization Name:HARRIS & BATRA CARDIOLOGY MEDICAL GROUP, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRES
Authorized Official - Prefix:
Authorized Official - First Name:CLIFFORD
Authorized Official - Middle Name:NORMAN
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:213-484-7968
Mailing Address - Street 1:PO BOX 10609
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91510-0609
Mailing Address - Country:US
Mailing Address - Phone:818-526-0200
Mailing Address - Fax:818-526-0258
Practice Address - Street 1:201 S ALVARADO
Practice Address - Street 2:SUITE 515
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90057
Practice Address - Country:US
Practice Address - Phone:213-484-7968
Practice Address - Fax:213-484-7886
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2009-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW12191Medicare PIN