Provider Demographics
NPI:1750616546
Name:HARFORDCARE, INC.
Entity type:Organization
Organization Name:HARFORDCARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KHALID
Authorized Official - Middle Name:ABDULLAH
Authorized Official - Last Name:KAMAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:805-451-5003
Mailing Address - Street 1:587 N VENTU PARK RD STE E803
Mailing Address - Street 2:
Mailing Address - City:NEWBURY PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91320-2723
Mailing Address - Country:US
Mailing Address - Phone:805-451-5003
Mailing Address - Fax:805-233-6639
Practice Address - Street 1:587 N VENTU PARK RD STE E803
Practice Address - Street 2:
Practice Address - City:NEWBURY PARK
Practice Address - State:CA
Practice Address - Zip Code:91320-2723
Practice Address - Country:US
Practice Address - Phone:805-451-5003
Practice Address - Fax:805-233-6639
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-12
Last Update Date:2010-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA41871OtherLICENSE
CACV564AMedicare PIN