Provider Demographics
NPI:1144269549
Name:MADAIN, LUZAN (DC)
Entity type:Individual
Prefix:
First Name:LUZAN
Middle Name:
Last Name:MADAIN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9670 PASO ROBLES AVE
Mailing Address - Street 2:
Mailing Address - City:NORTHRIDGE
Mailing Address - State:CA
Mailing Address - Zip Code:91325-1964
Mailing Address - Country:US
Mailing Address - Phone:661-424-0900
Mailing Address - Fax:661-424-0924
Practice Address - Street 1:18520 VIA PRINCESSA
Practice Address - Street 2:SUITE C-2
Practice Address - City:CANYON COUNTRY
Practice Address - State:CA
Practice Address - Zip Code:91387-8326
Practice Address - Country:US
Practice Address - Phone:661-424-0900
Practice Address - Fax:661-424-0924
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC27810111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC27810OtherCHIROPRATIC LICENSE
CAWDC27810AMedicare ID - Type UnspecifiedPPIN
CAV07150Medicare UPIN