Provider Demographics
NPI:1922398320
Name:HACKETT, LAUREN K (MD)
Entity Type:Individual
Prefix:DR
First Name:LAUREN
Middle Name:K
Last Name:HACKETT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:4050 BARRANCA PKWY STE 170
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92604-4785
Mailing Address - Country:US
Mailing Address - Phone:949-551-1090
Mailing Address - Fax:
Practice Address - Street 1:4050 BARRANCA PKWY STE 170
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92604-4785
Practice Address - Country:US
Practice Address - Phone:949-551-1090
Practice Address - Fax:949-262-5500
Is Sole Proprietor?:No
Enumeration Date:2011-04-19
Last Update Date:2021-06-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA114224208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics