Healthcare Provider Details

I. General information

NPI: 1003123936
Provider Name (Legal Business Name): SARAH ELIZABETH HARMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/14/2010
Last Update Date: 09/14/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 W VICTORIA ST
GARDENA CA
90248-3523
US

IV. Provider business mailing address

4902 TAMARACK WAY
IRVINE CA
92612-2835
US

V. Phone/Fax

Practice location:
  • Phone: 310-715-2020
  • Fax: 310-327-4723
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: