Healthcare Provider Details

I. General information

NPI: 1619250339
Provider Name (Legal Business Name): LUCAS PHIFER D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/20/2011
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1871 E THOUSAND OAKS BLVD
THOUSAND OAKS CA
91362-2912
US

IV. Provider business mailing address

1871 E THOUSAND OAKS BLVD
THOUSAND OAKS CA
91362-2912
US

V. Phone/Fax

Practice location:
  • Phone: 805-474-4224
  • Fax:
Mailing address:
  • Phone: 805-474-4224
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number32015
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: