Provider Demographics
NPI:1487684965
Name:HARRISON, GEORGE H (MD)
Entity Type:Individual
Prefix:
First Name:GEORGE
Middle Name:H
Last Name:HARRISON
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 1:1930 MARKET ST
Mailing Address - Street 2:AHP/UCSF
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94102-6228
Mailing Address - Country:US
Mailing Address - Phone:415-502-4818
Mailing Address - Fax:415-502-7240
Practice Address - Street 1:1930 MARKET ST
Practice Address - Street 2:AHP/UCSF
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94102-6228
Practice Address - Country:US
Practice Address - Phone:415-502-4818
Practice Address - Fax:415-502-7240
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2011-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG0728672084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G723670Medicare ID - Type Unspecified
F20769Medicare UPIN