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General NPI Number Information
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NPI Number | 1346130630
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Entity Type | Individual
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Provider Name | DANIEL LUKENCHUK DC
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Gender | Male
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Dates
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Enumeration Date | 07/08/2025
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Last Update Date | 07/08/2025
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Provider Practice Location Address
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Address Line | 629 CAMINO DE LOS MARES STE 104
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City | SAN CLEMENTE
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State | CA
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Zip | 92673-2829
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Country | US
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Telephone | 949-240-1334
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Fax |
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Provider Business Mailing Address
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Address Line | 629 CAMINO DE LOS MARES STE 104
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City | SAN CLEMENTE
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State | CA
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Zip | 92673-2829
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Country | US
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Telephone | 949-240-1334
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NS0005X
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Taxonomy Name | Sports Physician Chiropractor
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License Number | DC3712
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License Number State | CA
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