Provider Demographics
NPI:1821023755
Name:HARRISON, STEVEN A (MD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:A
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:PO BOX 1527
Mailing Address - Street 2:
Mailing Address - City:ORINDA
Mailing Address - State:CA
Mailing Address - Zip Code:94563-0682
Mailing Address - Country:US
Mailing Address - Phone:925-947-0505
Mailing Address - Fax:925-947-1515
Practice Address - Street 1:1299 NEWELL HILL PL
Practice Address - Street 2:SUITE 103
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94596-5292
Practice Address - Country:US
Practice Address - Phone:925-947-0505
Practice Address - Fax:925-947-1515
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2017-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG63736207W00000X, 207WX0107X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ28801ZOtherMEDICARE GROUP #
CA00G637360Medicaid
CA00G637360Medicaid
CA00G637360Medicare ID - Type Unspecified