Provider Demographics
NPI:1104847532
Name:HARRIS, STEVEN T (MD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:T
Last Name:HARRIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1635 DIVISADERO ST
Mailing Address - Street 2:SUITE 525
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94115-3036
Mailing Address - Country:US
Mailing Address - Phone:415-682-0914
Mailing Address - Fax:415-451-2167
Practice Address - Street 1:1635 DIVISADERO ST
Practice Address - Street 2:SUITE 525
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115-3044
Practice Address - Country:US
Practice Address - Phone:415-682-0914
Practice Address - Fax:415-451-2167
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-21
Last Update Date:2010-12-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG30282207R00000X, 207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G302820Medicaid
CAA44360Medicare UPIN
CA00G302820Medicaid