Provider Demographics
NPI:1871737767
Name:KOMER-BRIGHT, REBECCA LEE (REBECCA KOMER-BRIGHT)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:LEE
Last Name:KOMER-BRIGHT
Suffix:
Gender:F
Credentials:REBECCA KOMER-BRIGHT
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:LEE
Other - Last Name:BRIGHT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LAC
Mailing Address - Street 1:17531 CHARMAINE LN
Mailing Address - Street 2:
Mailing Address - City:YORBA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92886-5165
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:206 S PLACENTIA AVE
Practice Address - Street 2:
Practice Address - City:PLACENTIA
Practice Address - State:CA
Practice Address - Zip Code:92870-5710
Practice Address - Country:US
Practice Address - Phone:949-874-5233
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-23
Last Update Date:2016-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12997171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist