Individual
DR. GARY L. HARKINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1941 JOHNSON AVE, STE 201, SAN LUIS OBISPO, CA 93401-4169
(805) 543-5577
(805) 595-3231
Mailing address
1941 JOHNSON AVE, STE 201, SAN LUIS OBISPO, CA 93401-4169
(805) 543-5577
(805) 595-3231
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
G25721
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G257210
—
CA
01
—
1018
CMSP GRP PIN
CA
01
—
2257346
FIRST HEALTH PIN
—
01
—
CJ5643
RR MEDICARE PIN
—
01
—
G25721
MEDICAL LICENSE #
CA
05
—
GR0091140
—
CA
Enumeration date
06/13/2005
Last updated
07/09/2007
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