Provider Demographics
NPI:1043441090
Name:BOERLIN, HAROLD LOUIS III (MD)
Entity Type:Individual
Prefix:
First Name:HAROLD
Middle Name:LOUIS
Last Name:BOERLIN
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:15615 ALTON PKWY
Mailing Address - Street 2:SUITE 220
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-7305
Mailing Address - Country:US
Mailing Address - Phone:949-753-1143
Mailing Address - Fax:949-249-6601
Practice Address - Street 1:15615 ALTON PKWY
Practice Address - Street 2:SUITE 220
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618-7305
Practice Address - Country:US
Practice Address - Phone:949-753-1143
Practice Address - Fax:949-249-6601
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-06
Last Update Date:2010-04-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG 679572084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry