Provider Demographics
NPI:1073148011
Name:CARTER, HAROLD BERNARD III (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:HAROLD
Middle Name:BERNARD
Last Name:CARTER
Suffix:III
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 SIROS
Mailing Address - Street 2:
Mailing Address - City:LAGUNA NIGUEL
Mailing Address - State:CA
Mailing Address - Zip Code:92677-8918
Mailing Address - Country:US
Mailing Address - Phone:949-444-8254
Mailing Address - Fax:
Practice Address - Street 1:11705 SLATE AVE STE 100
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92505-5198
Practice Address - Country:US
Practice Address - Phone:949-444-8254
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-10
Last Update Date:2020-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA38315183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist