Provider Demographics
NPI:1942239579
Name:HARMAN, LAURA (MD)
Entity Type:Individual
Prefix:DR
First Name:LAURA
Middle Name:
Last Name:HARMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:325 W CHANNEL ISLANDS BLVD
Mailing Address - Street 2:
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93033-4501
Mailing Address - Country:US
Mailing Address - Phone:805-204-9500
Mailing Address - Fax:805-483-4379
Practice Address - Street 1:3555 LOMA VISTA RD
Practice Address - Street 2:SUITE 110
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003-3161
Practice Address - Country:US
Practice Address - Phone:805-653-0303
Practice Address - Fax:805-653-5761
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG85711207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1942239579Medicaid
CAZZZ50355YOtherBS/TRIWEST
CA1831365667Medicaid
CA1831365667Medicaid
CAH43224Medicare UPIN
CA1942239579Medicaid