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General NPI Number Information
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NPI Number | 1326296880
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Entity Type | Individual
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Provider Name | PHILLIP REGINALD HARDING M.D.
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Gender | Male
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Dates
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Enumeration Date | 09/08/2008
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Last Update Date | 01/12/2011
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Provider Practice Location Address
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Address Line | 101 E BEVERLY BLVD STE 103
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City | MONTEBELLO
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State | CA
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Zip | 90640-4314
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Country | US
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Telephone | 323-728-0655
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Fax | 323-728-7794
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Provider Business Mailing Address
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Address Line | 220 S 1ST ST
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City | ALHAMBRA
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State | CA
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Zip | 91801-3700
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Country | US
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Telephone | 626-281-8663
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Fax | 626-281-6318
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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 | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | A24876
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License Number State | CA
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