Individual provider Active NPI

Harold Lee Laue Jr., DC

  • Chiropractor
  • West Covina, CA
National Provider Identifier
1124009089
Registry record updated Nov 10, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
19888DC Issued in CA
Practice address
855 N Lark Ellen Ave
Suite H
West Covina, CA 91791-1099
Phone
(626) 339-5437
Fax
(626) 339-9978
NPI assigned
Nov 8, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 10, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 19888DC CA Primary

Addresses

Primary practice location

855 N Lark Ellen Ave
Suite H
West Covina, CA 91791-1099

Mailing address

855 N Lark Ellen Ave
Suite H
West Covina, CA 91791-1099
Phone (626) 339-5437

Other identifiers 1

IdentifierTypeStateIssuer
95-4392944OtherCAFEDERAL TAX ID

Other names 1

  • Dr. H. Lee Laue Jr. Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151125001263 CA Practitioner - Chiropractic 8820398720 Practice locations: West Covina, CA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
19888DCCAMDChiropractor
19888CAMDAdult Health Nurse Practitioner

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1131408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320883200000",
    "number": "1124009089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "855 N LARK ELLEN AVE",
            "address_2": "SUITE H",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917911099",
            "telephone_number": "626-339-5437",
            "fax_number": "626-339-9978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "855 N LARK ELLEN AVE",
            "address_2": "SUITE H",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917911099",
            "telephone_number": "626-339-5437",
            "fax_number": "626-339-9978"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAUE",
        "first_name": "HAROLD",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-08",
        "last_updated": "2011-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "19888DC",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEDERAL TAX ID",
            "identifier": "95-4392944",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "H.",
            "last_name": "LAUE",
            "middle_name": "LEE",
            "prefix": "DR.",
            "suffix": "JR.",
            "credential": "DC",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in West Covina, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.