Organization
HARBOR HEALTH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MATTHEW LEE (ADMINISTRATOR)
(619) 987-8078
Entity
Organization
Contact information
Practice address
34405 VIA GOMEZ, CAPISTRANO BEACH, CA 92624-1318
(949) 359-5669
Mailing address
34405 VIA GOMEZ, CAPISTRANO BEACH, CA 92624-1318
(949) 359-5669
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
—
—
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05D2288044
CLIA
CA
01
—
300722AP
DEPARTMENT OF HEALTH CARE SERVICES
CA
Enumeration date
04/27/2023
Last updated
01/13/2025
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