Provider Demographics
NPI:1710252648
Name:HARTON, MARY HAMASPIOUR (DO)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:HAMASPIOUR
Last Name:HARTON
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:345 PIONEER DR UNIT 1703
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91203-2743
Mailing Address - Country:US
Mailing Address - Phone:818-839-1094
Mailing Address - Fax:
Practice Address - Street 1:240 S JACKSON ST STE 109
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91205-1594
Practice Address - Country:US
Practice Address - Phone:818-839-1094
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-10
Last Update Date:2021-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A12088207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine