Provider Demographics
NPI:1689256067
Name:JAIN, HARSHWARDHAN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:HARSHWARDHAN
Middle Name:
Last Name:JAIN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6021 W DELAWARE CT
Mailing Address - Street 2:
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93291-9760
Mailing Address - Country:US
Mailing Address - Phone:559-730-8796
Mailing Address - Fax:
Practice Address - Street 1:6021 W DELAWARE CT
Practice Address - Street 2:
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93291-9760
Practice Address - Country:US
Practice Address - Phone:559-730-8796
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-25
Last Update Date:2021-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA82630183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist