Healthcare Provider Details

I. General information

NPI: 1477689347
Provider Name (Legal Business Name): HARBOR MEDICAL SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/26/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3162 NEWBERRY DR SUITE D
SAN JOSE CA
95118-1500
US

IV. Provider business mailing address

3162 NEWBERRY DR SUITE D
SAN JOSE CA
95118-1500
US

V. Phone/Fax

Practice location:
  • Phone: 408-978-1197
  • Fax: 408-978-2584
Mailing address:
  • Phone: 408-978-1197
  • Fax: 408-978-2584

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State

VIII. Authorized Official

Name: LISA BRACKEN
Title or Position: VICE PRESIDENT
Credential:
Phone: 408-978-1197