Healthcare Provider Details

I. General information

NPI: 1093072092
Provider Name (Legal Business Name): CATHERINE SY LUIB D.C., L.AC.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/13/2012
Last Update Date: 06/11/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9845 ERMA RD STE 301
SAN DIEGO CA
92131-1084
US

IV. Provider business mailing address

9845 ERMA RD STE 301
SAN DIEGO CA
92131-1084
US

V. Phone/Fax

Practice location:
  • Phone: 760-683-8738
  • Fax:
Mailing address:
  • Phone: 760-683-8738
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number31947
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code111NN1001X
TaxonomyNutrition Chiropractor
License Number31947
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number14752
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code111NP0017X
TaxonomyPediatric Chiropractor
License Number31947
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: