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General NPI Number Information
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NPI Number | 1215136957
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Entity Type | Individual
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Provider Name | DONALD T HARWICK P.A.
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Gender | Male
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Dates
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Enumeration Date | 07/12/2007
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Last Update Date | 07/12/2007
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Provider Practice Location Address
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Address Line | 9300 N LOOP BLVD SUITE A&B
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City | CALIFORNIA CITY
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State | CA
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Zip | 93505-2269
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Country | US
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Telephone | 760-373-1256
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Fax | 760-373-1214
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Provider Business Mailing Address
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Address Line | 9300 N LOOP BLVD SUITE A&B
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City | CALIFORNIA CITY
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State | CA
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Zip | 93505-2269
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Country | US
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Telephone | 760-373-1256
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Fax | 760-373-1214
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA13177
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License Number State | CA
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