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General NPI Number Information
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NPI Number | 1669448726
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Entity Type | Individual
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Provider Name | MICHAEL GAYLEN HARMON O.D.
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Gender | Male
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Dates
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Enumeration Date | 02/27/2006
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Last Update Date | 10/19/2020
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Provider Practice Location Address
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Address Line | 1817 SHAW AVE SUITE 104
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City | CLOVIS
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State | CA
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Zip | 93611-4069
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Country | US
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Telephone | 559-298-3601
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Fax | 559-298-6497
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Provider Business Mailing Address
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Address Line | 1817 SHAW AVE SUITE 104
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City | CLOVIS
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State | CA
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Zip | 93611-4069
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Country | US
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Telephone | 559-298-3601
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Fax | 559-298-6497
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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 | 152WC0802X
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Taxonomy Name | Corneal and Contact Management Optometrist
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License Number | 7211T
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License Number State | CA
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