Provider Demographics
NPI:1750438099
Name:SOUTH, HARLAN LUKE (MD)
Entity type:Individual
Prefix:DR
First Name:HARLAN
Middle Name:LUKE
Last Name:SOUTH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1170 SACRAMENTO ST APT 12B
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94108-1967
Mailing Address - Country:US
Mailing Address - Phone:415-316-5510
Mailing Address - Fax:
Practice Address - Street 1:490 POST ST STE 914
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94102-1410
Practice Address - Country:US
Practice Address - Phone:415-316-5510
Practice Address - Fax:415-449-6418
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-05
Last Update Date:2024-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC141433207R00000X
GA47534207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine