Provider Demographics
NPI:1184640872
Name:WATTS, HARVEY DAVID (MD)
Entity Type:Individual
Prefix:
First Name:HARVEY
Middle Name:DAVID
Last Name:WATTS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350 PARNASSUS AVE
Mailing Address - Street 2:SUITE 900
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94117-3604
Mailing Address - Country:US
Mailing Address - Phone:415-759-2121
Mailing Address - Fax:415-753-6600
Practice Address - Street 1:350 PARNASSUS AVE
Practice Address - Street 2:SUITE 900
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94117-3604
Practice Address - Country:US
Practice Address - Phone:415-759-2121
Practice Address - Fax:415-753-6600
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-14
Last Update Date:2012-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC29925207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA88925Medicare UPIN