Provider Demographics
NPI:1306221262
Name:KAZEM, HARON HASHMAT (DC)
Entity type:Individual
Prefix:DR
First Name:HARON
Middle Name:HASHMAT
Last Name:KAZEM
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 1:2214 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92101-2104
Mailing Address - Country:US
Mailing Address - Phone:858-863-6111
Mailing Address - Fax:
Practice Address - Street 1:2214 5TH AVE
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92101-2104
Practice Address - Country:US
Practice Address - Phone:858-863-6111
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-21
Last Update Date:2015-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA33295111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor