Provider Demographics
NPI:1144228180
Name:GROGIN, HARLAN ROBERT (MD)
Entity Type:Individual
Prefix:DR
First Name:HARLAN
Middle Name:ROBERT
Last Name:GROGIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:230 SAN JOSE ST
Mailing Address - Street 2:
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93901-3901
Mailing Address - Country:US
Mailing Address - Phone:831-758-2100
Mailing Address - Fax:831-758-1565
Practice Address - Street 1:230 SAN JOSE ST
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93901-3901
Practice Address - Country:US
Practice Address - Phone:831-758-2100
Practice Address - Fax:831-758-1565
Is Sole Proprietor?:No
Enumeration Date:2005-07-13
Last Update Date:2013-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG64014207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G640140Medicaid
CA060041807OtherRAILROAD MEDICARE SVMH READING
CA110116226OtherRAILROAD MEDICARE CCC
CAG00064014OtherBLUE CROSS
CA110116226OtherRAILROAD MEDICARE CCC
CA00G640142Medicare PIN
CA060041807OtherRAILROAD MEDICARE SVMH READING