Provider Demographics
NPI:1073553962
Name:HARRIS, CHRISTINA ELAINE (MD)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:ELAINE
Last Name:HARRIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:4140 W 190TH ST
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90504-5513
Mailing Address - Country:US
Mailing Address - Phone:310-423-6321
Mailing Address - Fax:
Practice Address - Street 1:8723 ALDEN DR
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90048-3692
Practice Address - Country:US
Practice Address - Phone:310-423-6321
Practice Address - Fax:310-423-0420
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2022-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC5104608207R00000X
CAC56051207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYG100000410Medicare Oscar/Certification
NYG100000410Medicare Oscar/Certification