Provider Demographics
NPI:1699844035
Name:HARRISON, YASUHARU (LAC)
Entity Type:Individual
Prefix:MR
First Name:YASUHARU
Middle Name:
Last Name:HARRISON
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2191 TORREY GLN
Mailing Address - Street 2:
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92026-1079
Mailing Address - Country:US
Mailing Address - Phone:760-739-1911
Mailing Address - Fax:760-739-3243
Practice Address - Street 1:3860 CONVOY ST
Practice Address - Street 2:SUITE 119
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92111-3748
Practice Address - Country:US
Practice Address - Phone:858-565-0386
Practice Address - Fax:858-565-0974
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC3322171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist