Provider Demographics
NPI:1649809971
Name:TODD HARSHBARGER MD, A MEDICAL CORPORATION
Entity type:Organization
Organization Name:TODD HARSHBARGER MD, A MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:TODD
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:HARSHBARGER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:213-787-7834
Mailing Address - Street 1:PO BOX 18111
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92817-8111
Mailing Address - Country:US
Mailing Address - Phone:213-787-7834
Mailing Address - Fax:213-559-0929
Practice Address - Street 1:191 S BUENA VISTA ST STE 370
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91505-4562
Practice Address - Country:US
Practice Address - Phone:213-787-7834
Practice Address - Fax:213-559-0929
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-07
Last Update Date:2020-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty