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NPI Code Detail

MEDICARE: DR. DANIEL ANTONIO LUJAN D.C.

MEDICARE: DR. DANIEL ANTONIO LUJAN D.C.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1111N00000XChiropractor4013OR
2111NN0400XNeurology Chiropractor4013OR
3111NN1001XNutrition Chiropractor4013OR
4111NP0017XPediatric Chiropractor4013OR
5111NR0200XRadiology Chiropractor4013OR
6111NR0400XRehabilitation Chiropractor4013OR
7111NS0005XSports Physician Chiropractor4013OR
8111NX0800XOrthopedic Chiropractor4013OR

General Provider Information

NPI Number : 1003132408
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DANIEL ANTONIO LUJAN D.C.
Provider Business Mailing Address
First Line : 4425 SW CORBETT AVE
Second Line :
City : PORTLAND
State : OR
Zip : 97239-4260
Country : US
Telephone Number : 503-225-9033
Fax Number : 503-225-9039
Provider Business Practice Location Address
First Line : 4425 SW CORBETT AVE
Second Line :
City : PORTLAND
State : OR
Zip : 97239-4260
Country : US
Telephone Number : 503-225-9033
Fax Number : 503-225-9039
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/12/2010
Last Update Date : 04/12/2010

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