Provider Demographics
NPI:1417635731
Name:HARSH, BREE (ELECTROLYSIS)
Entity Type:Individual
Prefix:
First Name:BREE
Middle Name:
Last Name:HARSH
Suffix:
Gender:F
Credentials:ELECTROLYSIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 PALATINE APT 104
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92612-7618
Mailing Address - Country:US
Mailing Address - Phone:949-300-7393
Mailing Address - Fax:
Practice Address - Street 1:2711 E COAST HWY STE 2
Practice Address - Street 2:
Practice Address - City:CORONA DEL MAR
Practice Address - State:CA
Practice Address - Zip Code:92625-2104
Practice Address - Country:US
Practice Address - Phone:949-228-9108
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-06
Last Update Date:2023-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA9818174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist