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NPI Code Detail

MEDICARE: DR. REX DELL HARNER M.D.

MEDICARE:  DR. REX DELL HARNER  M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine PhysicianG29415CA

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1080070430OTHERCARAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
200G294150OTHERCABLUE SHIELD OF CALIFORNIA
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1528066321
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. REX DELL HARNER M.D.
Provider Business Mailing Address
First Line : 3883 AIRWAY DR
Second Line :
City : SANTA ROSA
State : CA
Zip : 95403-1670
Country : US
Telephone Number : 707-521-8809
Fax Number : 707-521-8835
Provider Business Practice Location Address
First Line : 5300 SNYDER LN
Second Line : STE A
City : ROHNERT PARK
State : CA
Zip : 94928-2915
Country : US
Telephone Number : 707-585-8347
Fax Number : 707-585-8056
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/14/2005
Last Update Date : 04/30/2008

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Directions to “ DR. REX DELL HARNER M.D.” Practice Location

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