Provider Demographics
NPI:1972847895
Name:DANIEL HARVEY MD A P C MEDICINE
Entity Type:Organization
Organization Name:DANIEL HARVEY MD A P C MEDICINE
Other - Org Name:DANIEL HARVEY MD, A PROFESSIONAL CORPORATIO
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:HARVEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-513-9361
Mailing Address - Street 1:824 E. CARSON STREET
Mailing Address - Street 2:SUITE 206
Mailing Address - City:CARSON
Mailing Address - State:CA
Mailing Address - Zip Code:90745-2262
Mailing Address - Country:US
Mailing Address - Phone:310-513-9361
Mailing Address - Fax:310-513-9311
Practice Address - Street 1:824 E. CARSON STREET
Practice Address - Street 2:SUITE 206
Practice Address - City:CARSON
Practice Address - State:CA
Practice Address - Zip Code:90745-2262
Practice Address - Country:US
Practice Address - Phone:310-513-9361
Practice Address - Fax:310-513-9311
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DANIEL HARVEY,MD A P C MEDICINE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-11-15
Last Update Date:2020-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA54957207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty