MEDICARE: CURTIS L. HARMON

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
1	237700000X	Hearing Instrument Specialist	HA1716	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	HA0017160	OTHER	CA	MEDICAL PROVIDER #

General Provider Information

NPI Number	:	1871669309
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CURTIS L. HARMON

Provider Business Mailing Address
First Line	:	1115 N D ST
Second Line	:
City	:	SAN BERNARDINO
State	:	CA
Zip	:	92410-3523
Country	:	US
Telephone Number	:	909-888-7585
Fax Number	:	909-386-3609

Provider Business Practice Location Address
First Line	:	1115 N D ST
Second Line	:
City	:	SAN BERNARDINO
State	:	CA
Zip	:	92410-3523
Country	:	US
Telephone Number	:	909-888-7585
Fax Number	:	909-386-3609

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/27/2006
Last Update Date	:	07/08/2007

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