Provider Demographics
NPI:1366768525
Name:HARRIS, JILLION T (MD)
Entity type:Individual
Prefix:
First Name:JILLION
Middle Name:T
Last Name:HARRIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:8767 WILSHIRE BLVD FL 2
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90211-2714
Mailing Address - Country:US
Mailing Address - Phone:323-471-0954
Mailing Address - Fax:323-395-0644
Practice Address - Street 1:8767 WILSHIRE BLVD FL 2
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90211-2714
Practice Address - Country:US
Practice Address - Phone:323-471-0954
Practice Address - Fax:323-395-0644
Is Sole Proprietor?:No
Enumeration Date:2010-04-13
Last Update Date:2024-09-05
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA141442207Q00000X, 207Q00000X
GA069825207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine