Provider Demographics
NPI:1659360865
Name:HARER, KARL RICHARD (DC)
Entity Type:Individual
Prefix:DR
First Name:KARL
Middle Name:RICHARD
Last Name:HARER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4517 MARKET ST
Mailing Address - Street 2:SUITE 1
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93003-7710
Mailing Address - Country:US
Mailing Address - Phone:805-650-5929
Mailing Address - Fax:805-650-5947
Practice Address - Street 1:4517 MARKET ST
Practice Address - Street 2:SUITE 1
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003-7710
Practice Address - Country:US
Practice Address - Phone:805-650-5929
Practice Address - Fax:805-650-5947
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC17899111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW17875Medicare ID - Type Unspecified