Provider Demographics
NPI:1770320541
Name:JOEL LAZAR, PHD PC
Entity type:Organization
Organization Name:JOEL LAZAR, PHD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOEL
Authorized Official - Middle Name:
Authorized Official - Last Name:LAZAR
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:619-540-6038
Mailing Address - Street 1:1267 ROSECRANS ST STE E
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92106-2692
Mailing Address - Country:US
Mailing Address - Phone:619-540-6038
Mailing Address - Fax:858-755-2416
Practice Address - Street 1:1267 ROSECRANS ST STE E
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92106-2692
Practice Address - Country:US
Practice Address - Phone:619-540-6038
Practice Address - Fax:858-755-2416
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-10
Last Update Date:2024-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)