Provider Demographics
NPI:1427751221
Name:HYMES, LANZESTER (BS)
Entity type:Individual
Prefix:MR
First Name:LANZESTER
Middle Name:
Last Name:HYMES
Suffix:
Gender:M
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4991 IMPERIAL AVE
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92113-2063
Mailing Address - Country:US
Mailing Address - Phone:910-625-4045
Mailing Address - Fax:
Practice Address - Street 1:450 FLETCHER PKWY STE 226
Practice Address - Street 2:
Practice Address - City:EL CAJON
Practice Address - State:CA
Practice Address - Zip Code:92020-2595
Practice Address - Country:US
Practice Address - Phone:619-499-7999
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-22
Last Update Date:2023-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator