Individual provider Active NPI

David Zachary Harrison, M.D.

  • Emergency Medicine Physician
  • Los Angeles, CA
National Provider Identifier
1104189000
Registry record updated May 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
A127729 Issued in CA
Practice address
1200 N State St
Room 1060H
Los Angeles, CA 90089-1001
Phone
(323) 409-9000
NPI assigned
Jun 17, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 7, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X A127729 CA Primary

Addresses

Primary practice location

1200 N State St
Room 1060H
Los Angeles, CA 90089-1001

Mailing address

1200 N State St
Los Angeles, CA 90089-1001
Phone (323) 409-9000

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151125001904 CA Practitioner - Emergency Medicine 7315247236 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Tufts University School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southern California Permanente Medical GroupGroup PAC ID 6002729175, 11,250 clinicians

Practice addresses (Care Compare)

13652 Cantara St
Panorama City, CA 91402-5423
Phone (818) 375-2000

Hospital & facility affiliations

  • Kaiser Foundation Hospital - Panorama City Hospital, Panorama City, CA, CCN 050137

Merit-based Incentive Payment System (MIPS)

Final score
97.28 of 100Reported as group
Quality
89.92
Promoting interoperability
100
Improvement activities
40
Cost
78.23

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A127729CAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of California Emergency Medicine CurrentSince Jul 1, 2016 Accepting new patients
University of California SFGH Medical Group Current Accepting new patients
Permanente Medical Group Inc Emergency Medicine Current Accepting new patients
University of California SFGH Medical Group CurrentSince Sep 2, 2019 Accepting new patients
Permanente Medical Group, Inc CurrentSince Dec 27, 2022 Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients
Emergency Services Medical Corporation Emergency Medicine CurrentSince Mar 1, 2016 Accepting new patients
University of California SFGH Medical Group Emergency Medicine CurrentSince Sep 2, 2019 Accepting new patients
Avaly Health Medical Corporation Current Accepting new patients
Permanente Medical Group Inc Emergency Medicine CurrentSince Dec 27, 2022 Accepting new patients
Southern California Permanente Medical Group CurrentSince Jan 1, 2024 Accepting new patients

Locations

750 Auburn Ravine Rd
Auburn, CA 95603
Phone (530) 823-6131

4753 W Shaw Ave
Ste 101
Fresno, CA 93722
Phone (559) 277-8738

900 N Douty St
Hanford, CA 93230
Phone (559) 587-9014

25825 Vermont Ave
Harbor City, CA 90710
Phone (310) 325-5111

9300 Campus Point Dr
La Jolla, CA 92037
Phone (619) 957-7000

4601 Dale Rd
Modesto, CA 95356
Phone (209) 557-1000

13652 Cantara St
Panorama City, CA 91402
Phone (818) 375-2417

101 Monroe St
Petaluma, CA 94954
Phone (707) 763-4109

1150 Veterans Blvd
Redwood City, CA 94063
Phone (650) 299-2015

901 Nevin Ave
Richmond, CA 94801
Phone (510) 307-1500

930 W Main St
Ripon, CA 95366
Phone (209) 599-4221

501 J St
Sacramento, CA 95814
Phone (916) 497-3000

200 W Arbor Dr
San Diego, CA 92103
Phone (619) 543-5754

7901 Frost St
San Diego, CA 92123
Phone (619) 541-3400

1001 Potrero Ave
San Francisco, CA 94110
Phone (415) 206-2305

1001 Potrero Ave
Bldg 5
San Francisco, CA 94110
Phone (628) 206-5753

2200 Ofarrell St
San Francisco, CA 94115
Phone (415) 202-2000

710 Lawrence Expy
Santa Clara, CA 95051
Phone (408) 236-6400

5615 Scotts Valley Dr
Scotts Valley, CA 95066
Phone (831) 430-2700

7373 West Ln
Stockton, CA 95210
Phone (209) 476-2000

975 Sereno Dr
Vallejo, CA 94589
Phone (707) 651-1000

320 N Crawford St
Willows, CA 95988
Phone (530) 934-2834

Organizations & group practices 11

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1339891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715040000000",
    "number": "1104189000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 N STATE ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900891001",
            "telephone_number": "323-409-9000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 N STATE ST",
            "address_2": "ROOM 1060H",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900891001",
            "telephone_number": "323-409-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRISON",
        "first_name": "DAVID",
        "middle_name": "ZACHARY",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-06-17",
        "last_updated": "2024-05-07",
        "certification_date": "2022-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A127729",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "13652 Cantara St",
            "city": "Panorama City",
            "state": "CA",
            "country_code": "US",
            "postal_code": "914025423",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.