Provider Demographics
NPI:1376891812
Name:HUSTED, HARLAN M (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:HARLAN
Middle Name:M
Last Name:HUSTED
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:6737 N MILBURN AVE
Mailing Address - Street 2:STE 160 PMB 38
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93722-2141
Mailing Address - Country:US
Mailing Address - Phone:559-434-0183
Mailing Address - Fax:
Practice Address - Street 1:2823 FRESNO STREET
Practice Address - Street 2:COMMUNITY REGIONAL MED CTR - INPATIENT PHARMACY
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93715
Practice Address - Country:US
Practice Address - Phone:559-459-6295
Practice Address - Fax:559-459-7377
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-15
Last Update Date:2012-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA575791835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy