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Lucent Chiropractic

Preferred Provider Organization in Los Angeles, CA. Organization (NPI-2).

NPI number1063667152
StatusActive
Last updated in NPPESNov 17, 2008

Details

NPI
1063667152
Entity type
Organization (NPI-2)
Legal business name
Lucent Chiropractic
Organization subpart
No
Enumeration date
Nov 17, 2008
Last updated
Nov 17, 2008

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
305R00000X Preferred Provider Organizationdc30358CAYes

Practice location

11633 San Vicente Blvd
Suite 214
Los Angeles, CA 90049-6511

Phone 310-592-7095 · Fax 310-826-9894

Mailing address

11633 San Vicente Blvd
Suite 214
Los Angeles, CA 90049-6511

Phone 310-592-7095 · Fax 310-826-9894

Authorized official

Serge C Lazatin
Chiropractor
3105927095

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