Provider Demographics
NPI:1063869196
Name:HARLOW, JOHN BANKS (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:BANKS
Last Name:HARLOW
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 1:807 HYPERION AVENUE
Mailing Address - Street 2:APT 7
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90029
Mailing Address - Country:US
Mailing Address - Phone:202-436-0710
Mailing Address - Fax:
Practice Address - Street 1:807 HYPERION AVE
Practice Address - Street 2:APT 7
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90029-3157
Practice Address - Country:US
Practice Address - Phone:202-436-0710
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-18
Last Update Date:2016-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA39208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics