Provider Demographics
NPI:1366479123
Name:HARDIN, EUGENE - (MD)
Entity Type:Individual
Prefix:
First Name:EUGENE
Middle Name:-
Last Name:HARDIN
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 1:357 E CARSON ST
Mailing Address - Street 2:102
Mailing Address - City:CARSON
Mailing Address - State:CA
Mailing Address - Zip Code:90745-2745
Mailing Address - Country:US
Mailing Address - Phone:310-518-2737
Mailing Address - Fax:310-518-2060
Practice Address - Street 1:357 E CARSON ST
Practice Address - Street 2:102
Practice Address - City:CARSON
Practice Address - State:CA
Practice Address - Zip Code:90745-2745
Practice Address - Country:US
Practice Address - Phone:310-518-2737
Practice Address - Fax:310-518-2060
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA32643207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine