Healthcare Provider Details

I. General information

NPI: 1104036573
Provider Name (Legal Business Name): ANNALEE CARSWELL HULBURT IBCLC, RLC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/23/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6035 HILLPOINTE ROW
LA JOLLA CA
92037-0925
US

IV. Provider business mailing address

6035 HILLPOINTE ROW
LA JOLLA CA
92037-0925
US

V. Phone/Fax

Practice location:
  • Phone: 858-740-7900
  • Fax: 858-551-2624
Mailing address:
  • Phone: 858-740-7900
  • Fax: 858-551-2624

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: