Provider Demographics
NPI:1942301445
Name:PFIEFLE, HARVEY DWAYNE (MD)
Entity Type:Individual
Prefix:
First Name:HARVEY
Middle Name:DWAYNE
Last Name:PFIEFLE
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 1:3975 JACKSON ST STE 101
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92503-3938
Mailing Address - Country:US
Mailing Address - Phone:951-688-3432
Mailing Address - Fax:951-688-3436
Practice Address - Street 1:3975 JACKSON ST STE 101
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92503-3938
Practice Address - Country:US
Practice Address - Phone:951-688-3432
Practice Address - Fax:951-688-3436
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-26
Last Update Date:2008-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA34821207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A348210Medicare PIN
CAA88308Medicare UPIN