Provider Demographics
NPI:1346347028
Name:HARMON, GREGORY SCOT (MD)
Entity Type:Individual
Prefix:
First Name:GREGORY
Middle Name:SCOT
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 1:20911 EARL ST STE 220
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90503-4353
Mailing Address - Country:US
Mailing Address - Phone:310-214-7236
Mailing Address - Fax:310-542-0334
Practice Address - Street 1:20911 EARL ST STE 220
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90503-4353
Practice Address - Country:US
Practice Address - Phone:310-214-7236
Practice Address - Fax:310-542-0334
Is Sole Proprietor?:No
Enumeration Date:2006-09-17
Last Update Date:2022-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA79243207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1346347028OtherCCS PANELED
CA1346347028Medicaid
CA1346347028Medicaid