Basic Information
| Provider Information | |||||||||
| NPI: | 1871734251 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HARRIS | ||||||||
| FirstName: | BECHAEL | ||||||||
| MiddleName: | SYANDENE | ||||||||
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| Credential: | LVN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 541 SOUTH CLYMAR AVENUE | ||||||||
| Address2: | |||||||||
| City: | COMPTON | ||||||||
| State: | CA | ||||||||
| PostalCode: | 902203319 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3107634270 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 2414 N BROADWAY | ||||||||
| Address2: | #201 | ||||||||
| City: | LOS ANGELES | ||||||||
| State: | CA | ||||||||
| PostalCode: | 900312359 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3236442000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/16/2009 | ||||||||
| LastUpdateDate: | 10/05/2010 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 164X00000X | VN181322 | CA | Y | Nursing Service Providers | Licensed Vocational Nurse |
No ID Information.