Healthcare Provider Details

I. General information

NPI: 1477480911
Provider Name (Legal Business Name): CORESHIFT CHIROPRACTIC AND WELLNESS LAM-LUU INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/07/2026
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

481 N CENTRAL AVE STE B
UPLAND CA
91786-7283
US

IV. Provider business mailing address

481 N CENTRAL AVE STE B
UPLAND CA
91786-7283
US

V. Phone/Fax

Practice location:
  • Phone: 909-946-8900
  • Fax: 909-946-8958
Mailing address:
  • Phone: 909-946-8900
  • Fax: 909-946-8958

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: TRACY LAM-LUU
Title or Position: CEO
Credential: DC
Phone: 626-478-6733