Provider Demographics
NPI:1982905402
Name:HARLAN, MICHAEL CARLETON
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:CARLETON
Last Name:HARLAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31202 GARDENSIDE LN
Mailing Address - Street 2:
Mailing Address - City:MENIFEE
Mailing Address - State:CA
Mailing Address - Zip Code:92584-8299
Mailing Address - Country:US
Mailing Address - Phone:760-851-4271
Mailing Address - Fax:
Practice Address - Street 1:552 S PASEO DOROTEA
Practice Address - Street 2:SUITE 2
Practice Address - City:PALM SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92264-1437
Practice Address - Country:US
Practice Address - Phone:760-851-4271
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-15
Last Update Date:2010-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic