Provider Demographics
NPI:1174768899
Name:HARRIS L. GREENWALD, M.D., INC.
Entity type:Organization
Organization Name:HARRIS L. GREENWALD, M.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:M.D./OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HARRIS
Authorized Official - Middle Name:L
Authorized Official - Last Name:GREENWALD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:661-254-3232
Mailing Address - Street 1:23861 MCBEAN PKWY STE B2
Mailing Address - Street 2:
Mailing Address - City:VALENCIA
Mailing Address - State:CA
Mailing Address - Zip Code:91355-2003
Mailing Address - Country:US
Mailing Address - Phone:661-254-3232
Mailing Address - Fax:
Practice Address - Street 1:23861 MCBEAN PKWY STE B2
Practice Address - Street 2:
Practice Address - City:VALENCIA
Practice Address - State:CA
Practice Address - Zip Code:91355-2003
Practice Address - Country:US
Practice Address - Phone:661-254-3232
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-09
Last Update Date:2008-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG20771208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty