Individual
LAWRENCE B HARKLESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
795 E 2ND ST, SUITE 7, POMONA, CA 91766-2007
(909) 706-3877
(909) 706-3942
Mailing address
795 E 2ND ST, SUITE 7, POMONA, CA 91766-2007
(909) 706-3877
(909) 706-3942
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
E4746
CA
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
E4746
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AR222Y
MEDICARE SO CA PTAN
CA
01
—
AR222Z
MEDICARE NO CA PTAN
CA
01
—
E4746
STATE LICENSE
CA
01
—
PO1001250
RAILROAD MEDICARE
CA
Enumeration date
08/24/2006
Last updated
04/10/2013
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