Provider Demographics
NPI:1306875919
Name:PIERCE, LEE D (DC)
Entity type:Individual
Prefix:DR
First Name:LEE
Middle Name:D
Last Name:PIERCE
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 1:17024 MAGNOLIA ST
Mailing Address - Street 2:
Mailing Address - City:FOUNTAIN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92708-3204
Mailing Address - Country:US
Mailing Address - Phone:714-848-4323
Mailing Address - Fax:877-288-0153
Practice Address - Street 1:17024 MAGNOLIA ST
Practice Address - Street 2:
Practice Address - City:FOUNTAIN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92708-3204
Practice Address - Country:US
Practice Address - Phone:714-848-4323
Practice Address - Fax:877-288-0153
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA15012111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC15012Medicare ID - Type UnspecifiedCHIROPRACTIC