Individual provider Active NPI

Ansar M Haroun, MD

  • Forensic Psychiatry Physician
  • San Diego, CA
National Provider Identifier
1174630404
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Forensic Psychiatry PhysicianTaxonomy code 2084F0202X
License
A43260 Issued in CA
Practice address
220 W Broadway
Forensic Psychiatry Clinic # 1003
San Diego, CA 92101-3886
Phone
(619) 531-3065
Fax
(619) 531-3668
NPI assigned
Aug 24, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Forensic Psychiatry Physician 2084F0202X A43260 CA Primary

Addresses

Primary practice location

220 W Broadway
Forensic Psychiatry Clinic # 1003
San Diego, CA 92101-3886

Mailing address

5475 Bragg St
San Diego, CA 92122-4103
Phone (619) 531-3065

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A43260CAMDForensic Psychiatry Physician

NPI Registry JSON

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

{
    "created_epoch": "1156377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1174630404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5475 BRAGG ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921224103",
            "telephone_number": "619-531-3065",
            "fax_number": "619-531-3668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 W BROADWAY",
            "address_2": "FORENSIC PSYCHIATRY CLINIC # 1003",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921013886",
            "telephone_number": "619-531-3065",
            "fax_number": "619-531-3668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAROUN",
        "first_name": "ANSAR",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084F0202X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Forensic Psychiatry",
            "state": "CA",
            "license": "A43260",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.