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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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 12 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1396859393 NPPES
California Other P00469231 RR MEDICARE
California MEDICAID 1396859393 RR MEDICARE
California Other 00A611200 RR MEDICARE

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