Provider Demographics
NPI:1669448726
Name:HARMON, MICHAEL GAYLEN (OD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:GAYLEN
Last Name:HARMON
Suffix:
Gender:M
Credentials:OD
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Mailing Address - Street 1:1817 SHAW AVE
Mailing Address - Street 2:SUITE 104
Mailing Address - City:CLOVIS
Mailing Address - State:CA
Mailing Address - Zip Code:93611-4069
Mailing Address - Country:US
Mailing Address - Phone:559-298-3601
Mailing Address - Fax:559-298-6497
Practice Address - Street 1:1817 SHAW AVE
Practice Address - Street 2:SUITE 104
Practice Address - City:CLOVIS
Practice Address - State:CA
Practice Address - Zip Code:93611-4069
Practice Address - Country:US
Practice Address - Phone:559-298-3601
Practice Address - Fax:559-298-6497
Is Sole Proprietor?:No
Enumeration Date:2006-02-27
Last Update Date:2020-10-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CA7211T152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management