Active NPI
David Mardell Harris, M.D.
- Family Medicine Physician
- San Diego, CA
National Provider Identifier
1306278338
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 31163
- Practice address
- Naval Medical Ctr 34800 Bob Wilson Drive
San Diego, CA 92134-5000 - Phone
- (619) 524-6912
- NPI assigned
- Aug 1, 2013
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 31163 | OK | Primary |
Addresses
Primary practice location
Naval Medical Ctr 34800 Bob Wilson Drive
San Diego, CA 92134-5000
Mailing address
Naval Medical Ctr 34800 Bob Wilson Drive
San Diego, CA 92134-5000
Other practice location 1
Santa Margarita Road Building H100
Camp Pendleton, CA 92055
Phone (760) 725-8882
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| VAD0000 | Medicaid | OK |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 31163 | OK | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1375315200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1615507200000",
"number": "1306278338",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "NAVAL MEDICAL CTR 34800 BOB WILSON DRIVE",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921345000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "NAVAL MEDICAL CTR 34800 BOB WILSON DRIVE",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921345000",
"telephone_number": "619-524-6912"
}
],
"practiceLocations": [
{
"address_1": "Santa Margarita Road Building H100",
"address_purpose": "LOCATION",
"city": "Camp Pendleton",
"state": "CA",
"postal_code": "92055",
"country_code": "US",
"telephone_number": "760-725-8882",
"fax_number": "760-725-1267",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HARRIS",
"first_name": "DAVID",
"middle_name": "MARDELL",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-08-01",
"last_updated": "2021-03-12",
"certification_date": "2021-03-12",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "OK",
"license": "31163",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "VAD0000",
"state": "OK"
}
],
"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 Mar 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.