Provider Demographics
NPI:1336573054
Name:HARAS, GEORGE (PT)
Entity Type:Individual
Prefix:
First Name:GEORGE
Middle Name:
Last Name:HARAS
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1655 TARAVAL ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94116-2353
Mailing Address - Country:US
Mailing Address - Phone:415-858-3391
Mailing Address - Fax:415-840-7191
Practice Address - Street 1:1655 TARAVAL ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94116-2353
Practice Address - Country:US
Practice Address - Phone:415-858-3391
Practice Address - Fax:415-840-7191
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-29
Last Update Date:2015-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT 40496225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist