Healthcare Provider Details

I. General information

NPI: 1144269549
Provider Name (Legal Business Name): LUZAN MADAIN D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/04/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18520 VIA PRINCESSA SUITE C-2
CANYON COUNTRY CA
91387-8326
US

IV. Provider business mailing address

9670 PASO ROBLES AVE
NORTHRIDGE CA
91325-1964
US

V. Phone/Fax

Practice location:
  • Phone: 661-424-0900
  • Fax: 661-424-0924
Mailing address:
  • Phone: 661-424-0900
  • Fax: 661-424-0924

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC27810
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: