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General NPI Number Information
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NPI Number | 1023326923
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Entity Type | Individual
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Provider Name | DUSTIN JAMES HARN PA-C
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Gender | Male
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Dates
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Enumeration Date | 09/14/2010
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Last Update Date | 05/15/2018
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Provider Practice Location Address
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Address Line | 1002 CAMPUS AVE
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City | REDLANDS
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State | CA
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Zip | 92374
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Country | US
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Telephone | 951-768-4615
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Fax |
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Provider Business Mailing Address
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Address Line | 1002 CAMPUS AVE
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City | REDLANDS
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State | CA
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Zip | 92374-3617
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Country | US
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Telephone | 951-768-4615
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA185732
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA21142
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License Number State | CA
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