Harris, Abdul Kezin
Harris, Abdul Kezin is an individual health care provider with primary practice located at 1701 4Th St Ste 200, Santa Rosa CA 95404-3601. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Surgery, Allopathic & Osteopathic Physicians / Trauma Surgery. Allopathic & Osteopathic Physicians / Surgery is his primary health care specialty. Harris, Abdul Kezin can be contacted via phone (707) 579-2100.Contact Information
Primary practice address
1701 4Th St Ste 200
Santa Rosa CA 95404-3601
Phone: (707) 579-2100
Fax: (707) 523-0616
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | A61120 | California |
| Allopathic & Osteopathic Physicians / Trauma Surgery | 2086S0127X | A61120 | California |
Profile Details
| NPI number | 1396859393 |
|---|---|
| LBN Legal business name | Harris, Abdul Kezin |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 18th, 2006 |
| Last updated | Feb 7th, 2012 - about 14 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1396859393 | NPPES |
| California | Other | P00469231 | RR MEDICARE |
| California | MEDICAID | 1396859393 | RR MEDICARE |
| California | Other | 00A611200 | RR MEDICARE |
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