Provider Demographics
NPI:1154593655
Name:HARRIS MUSAFER MD INC
Entity type:Organization
Organization Name:HARRIS MUSAFER MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST/MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:KANEEZA
Authorized Official - Middle Name:
Authorized Official - Last Name:LAFIR
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:562-773-3044
Mailing Address - Street 1:12006 ROSECRANS AVE
Mailing Address - Street 2:
Mailing Address - City:NORWALK
Mailing Address - State:CA
Mailing Address - Zip Code:90650-4119
Mailing Address - Country:US
Mailing Address - Phone:562-863-7007
Mailing Address - Fax:562-929-0516
Practice Address - Street 1:12006 ROSECRANS AVE
Practice Address - Street 2:
Practice Address - City:NORWALK
Practice Address - State:CA
Practice Address - Zip Code:90650-4119
Practice Address - Country:US
Practice Address - Phone:562-863-7007
Practice Address - Fax:562-929-0516
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-25
Last Update Date:2008-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA30372207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A303720Medicaid
CAA30372Medicare PIN
CAA26085Medicare UPIN