Healthcare Provider Details

I. General information

NPI: 1053810069
Provider Name (Legal Business Name): HARLAN MEDICAL CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/05/2018
Last Update Date: 03/06/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5300 GEARY BLVD STE 300
SAN FRANCISCO CA
94121-2355
US

IV. Provider business mailing address

5300 GEARY BLVD STE 300
SAN FRANCISCO CA
94121-2355
US

V. Phone/Fax

Practice location:
  • Phone: 415-933-7788
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: HARLAN SOUTH
Title or Position: OWNER
Credential:
Phone: 415-933-7788