Provider Demographics
NPI:1992127211
Name:POWERS, HARLAN ANNSWORTH (MD (AM), MPH)
Entity type:Individual
Prefix:DR
First Name:HARLAN
Middle Name:ANNSWORTH
Last Name:POWERS
Suffix:
Gender:F
Credentials:MD (AM), MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:BOX 3184
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90212
Mailing Address - Country:US
Mailing Address - Phone:818-619-8664
Mailing Address - Fax:
Practice Address - Street 1:9595 WILSHIRE BLVD
Practice Address - Street 2:SUITE 900
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90212-2512
Practice Address - Country:US
Practice Address - Phone:818-619-8664
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-07
Last Update Date:2017-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ZZ9765541302086S0122X
HI91178547208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery