Provider Demographics
NPI:1407059892
Name:HUNGER, EDWIN LEE
Entity Type:Individual
Prefix:
First Name:EDWIN
Middle Name:LEE
Last Name:HUNGER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:E
Other - Middle Name:LEE
Other - Last Name:HUNGER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:8885 RIO SAN DIEGO DR
Mailing Address - Street 2:#347
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92108
Mailing Address - Country:US
Mailing Address - Phone:619-993-1378
Mailing Address - Fax:613-260-1244
Practice Address - Street 1:8885 RIO SAN DIEGO DR
Practice Address - Street 2:#347
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108
Practice Address - Country:US
Practice Address - Phone:619-993-1378
Practice Address - Fax:613-260-1244
Is Sole Proprietor?:No
Enumeration Date:2007-06-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA19161DC111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA19161OtherSTATE CHIROPRACTIC LICENS