Provider Demographics
NPI:1154804557
Name:HARRIS WASSER MD INC
Entity type:Organization
Organization Name:HARRIS WASSER MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HARRIS
Authorized Official - Middle Name:L
Authorized Official - Last Name:WASSER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:805-522-4004
Mailing Address - Street 1:1687 ERRINGER RD STE 215
Mailing Address - Street 2:
Mailing Address - City:SIMI VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93065-6510
Mailing Address - Country:US
Mailing Address - Phone:805-522-4004
Mailing Address - Fax:805-583-3709
Practice Address - Street 1:1687 ERRINGER RD STE 215
Practice Address - Street 2:
Practice Address - City:SIMI VALLEY
Practice Address - State:CA
Practice Address - Zip Code:93065-6510
Practice Address - Country:US
Practice Address - Phone:805-522-4004
Practice Address - Fax:805-583-3709
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-11
Last Update Date:2018-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Multi-Specialty