Provider Demographics
NPI:1518985985
Name:TARLETON, HAROLD L (MD)
Entity Type:Individual
Prefix:DR
First Name:HAROLD
Middle Name:L
Last Name:TARLETON
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 1:39000 BOB HOPE DR
Mailing Address - Street 2:SUITE K406
Mailing Address - City:RANCHO MIRAGE
Mailing Address - State:CA
Mailing Address - Zip Code:92270-3221
Mailing Address - Country:US
Mailing Address - Phone:760-836-0708
Mailing Address - Fax:760-773-4293
Practice Address - Street 1:39000 BOB HOPE DR
Practice Address - Street 2:SUITE K406
Practice Address - City:RANCHO MIRAGE
Practice Address - State:CA
Practice Address - Zip Code:92270-3221
Practice Address - Country:US
Practice Address - Phone:760-836-0708
Practice Address - Fax:760-773-4293
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2016-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC32824207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
C81494Medicare UPIN