Organization Active NPI

Norman J Harris Mda Prof Corp

  • Otolaryngology Physician
  • Fullerton, CA
National Provider Identifier
1194784553
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
G42488 Issued in CA
Legal business name
NORMAN J HARRIS MDA PROF CORP
Practice address
100 E Valencia Mesa Dr
Ste 111
Fullerton, CA 92835
Phone
(714) 441-0133
Fax
(714) 441-1082
NPI assigned
Mar 22, 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
Denise L Gaskin
Title
Accts Manager
Phone
(714) 441-0133

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Y00000X G42488 CA Primary

Addresses

Primary practice location

100 E Valencia Mesa Dr
Ste 111
Fullerton, CA 92835

Mailing address

100 E Valencia Mesa Dr
Ste 111
Fullerton, CA 92835
Phone (714) 441-0133

Other names 1

  • Affiliated Ear Nose and Throat Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1142985600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1194784553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 E VALENCIA MESA DR",
            "address_2": "STE 111",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "92835",
            "telephone_number": "714-441-0133",
            "fax_number": "714-441-1082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E VALENCIA MESA DR",
            "address_2": "STE 111",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "92835",
            "telephone_number": "714-441-0133",
            "fax_number": "714-441-1082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORMAN J HARRIS MDA PROF CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GASKIN",
        "authorized_official_first_name": "DENISE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "ACCTS MANAGER",
        "authorized_official_telephone_number": "714-441-0133"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology",
            "state": "CA",
            "license": "G42488",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Affiliated Ear Nose and Throat",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fullerton, 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.