Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | G86180 | CA |
N | 207ND0900X | Dermatopathologist | G86180 | CA |
N | 207NS0135X | Procedural Dermatology | G86180 | CA |
NPI | 1073596870 |
---|---|
Provider Name | Robert Harford |
First Address | Hemet, CA 92543-4370 |
Second Address | Hemet, CA 92543-4370 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/11/2005 |
Last Update Date | 26/12/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
I31957 | (02) | CA |
Y36439 | (02) | CA |