Provider Demographics
NPI:1225069537
Name:HARMON, ADAM L (MD)
Entity Type:Individual
Prefix:DR
First Name:ADAM
Middle Name:L
Last Name:HARMON
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 1:3400 DATA DR
Mailing Address - Street 2:
Mailing Address - City:RANCHO CORDOVA
Mailing Address - State:CA
Mailing Address - Zip Code:95670-7956
Mailing Address - Country:US
Mailing Address - Phone:916-379-2729
Mailing Address - Fax:
Practice Address - Street 1:2900 WHIPPLE AVE
Practice Address - Street 2:SUITE 140
Practice Address - City:REDWOOD CITY
Practice Address - State:CA
Practice Address - Zip Code:94062-2843
Practice Address - Country:US
Practice Address - Phone:650-261-2366
Practice Address - Fax:650-261-2369
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2014-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG77973208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A618120Medicaid
CACP2153OtherRAILROAD MEDICARE
CACP2153OtherRAILROAD MEDICARE
CAZZZ02406ZMedicare PIN
CAF78487Medicare UPIN
CA00A618120Medicaid
CA00G779732Medicare PIN
CA00G779735Medicare PIN
CAZZZ23469ZMedicare PIN