Organization Active NPI

David R Harris MD a Medical Corporation

  • Procedural Dermatology Physician
  • Campbell, CA
National Provider Identifier
1053485599
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Procedural Dermatology PhysicianTaxonomy code 207NS0135X
License
C28356 Issued in CA
Legal business name
DAVID R HARRIS MD A MEDICAL CORPORATION
Practice address
3803 S Bascom Ave
Suite 200
Campbell, CA 95008-7317
Phone
(408) 559-0988
Fax
(408) 369-4263
NPI assigned
Nov 17, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. David Robert Harris, M.D.
Title
Diplomate American Board of Dermato
Phone
(408) 559-0988

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Procedural Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207NS0135X C28356 CA Primary

Addresses

Primary practice location

3803 S Bascom Ave
Suite 200
Campbell, CA 95008-7317

Mailing address

3803 S Bascom Ave
Suite 200
Campbell, CA 95008-7317
Phone (408) 559-0988

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1053485599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3803 S BASCOM AVE",
            "address_2": "SUITE 200",
            "city": "CAMPBELL",
            "state": "CA",
            "postal_code": "950087317",
            "telephone_number": "408-559-0988",
            "fax_number": "408-369-4263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3803 S BASCOM AVE",
            "address_2": "SUITE 200",
            "city": "CAMPBELL",
            "state": "CA",
            "postal_code": "950087317",
            "telephone_number": "408-559-0988",
            "fax_number": "408-369-4263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID R HARRIS MD A MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HARRIS",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "DIPLOMATE AMERICAN BOARD OF DERMATO",
        "authorized_official_telephone_number": "408-559-0988",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207NS0135X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "CA",
            "license": "C28356",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Campbell, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.