Healthcare Provider Details

I. General information

NPI: 1871748731
Provider Name (Legal Business Name): CYNTHIA ANN LUCE D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/19/2008
Last Update Date: 07/09/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

420 OLD COUNTY RD
PACIFICA CA
94044-3221
US

IV. Provider business mailing address

82 LAUSANNE AVE #2
DALY CITY CA
94014-1875
US

V. Phone/Fax

Practice location:
  • Phone: 650-359-6800
  • Fax:
Mailing address:
  • Phone: 650-888-8829
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC25250
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: