Provider Demographics
NPI:1326644634
Name:HARROLD, DAVID J (MEDICAL ASSISTANT/PH)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:J
Last Name:HARROLD
Suffix:
Gender:M
Credentials:MEDICAL ASSISTANT/PH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13920 BREGER AVE
Mailing Address - Street 2:
Mailing Address - City:SYLMAR
Mailing Address - State:CA
Mailing Address - Zip Code:91342-1737
Mailing Address - Country:US
Mailing Address - Phone:877-506-4320
Mailing Address - Fax:
Practice Address - Street 1:13920 BREGER AVE
Practice Address - Street 2:
Practice Address - City:SYLMAR
Practice Address - State:CA
Practice Address - Zip Code:91342-1737
Practice Address - Country:US
Practice Address - Phone:877-506-4320
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-10
Last Update Date:2020-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACPT00023827246RP1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy