Healthcare Provider Details

I. General information

NPI: 1831726330
Provider Name (Legal Business Name): GARRETT HARADA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/25/2020
Last Update Date: 08/24/2025
Certification Date: 08/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 THE CITY DR S BLDG 23
ORANGE CA
92868-3201
US

IV. Provider business mailing address

101 THE CITY DR S BLDG 23
ORANGE CA
92868-3201
US

V. Phone/Fax

Practice location:
  • Phone: 714-456-8000
  • Fax:
Mailing address:
  • Phone: 714-456-8000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License NumberA182708
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: