Provider Demographics
NPI:1497876205
Name:HAZEN, LEE JAMES (DC)
Entity Type:Individual
Prefix:DR
First Name:LEE
Middle Name:JAMES
Last Name:HAZEN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27450 YNEZ RD STE 100
Mailing Address - Street 2:
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92591-4649
Mailing Address - Country:US
Mailing Address - Phone:951-383-4333
Mailing Address - Fax:951-506-2361
Practice Address - Street 1:27450 YNEZ RD STE 100
Practice Address - Street 2:
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92591-4649
Practice Address - Country:US
Practice Address - Phone:951-383-4333
Practice Address - Fax:951-506-2361
Is Sole Proprietor?:No
Enumeration Date:2007-04-02
Last Update Date:2015-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA19825111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC0198250Medicare PIN
CAT89994Medicare UPIN