Provider Demographics
NPI:1336290592
Name:MORTON, CAROL LYNNE (LAC)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:LYNNE
Last Name:MORTON
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26321 OZONE AVE
Mailing Address - Street 2:
Mailing Address - City:HARBOR CITY
Mailing Address - State:CA
Mailing Address - Zip Code:90710-3629
Mailing Address - Country:US
Mailing Address - Phone:310-535-1700
Mailing Address - Fax:
Practice Address - Street 1:26321 OZONE AVE
Practice Address - Street 2:
Practice Address - City:HARBOR CITY
Practice Address - State:CA
Practice Address - Zip Code:90710-3629
Practice Address - Country:US
Practice Address - Phone:310-535-1700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AC7769171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist