Provider Demographics
NPI:1437392925
Name:CLIFTON, LANCE BENJAMIN (DC)
Entity Type:Individual
Prefix:DR
First Name:LANCE
Middle Name:BENJAMIN
Last Name:CLIFTON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7880 OLD AUBURN RD
Mailing Address - Street 2:
Mailing Address - City:CITRUS HEIGHTS
Mailing Address - State:CA
Mailing Address - Zip Code:95610-3027
Mailing Address - Country:US
Mailing Address - Phone:916-723-8282
Mailing Address - Fax:916-723-8276
Practice Address - Street 1:7880 OLD AUBURN RD
Practice Address - Street 2:
Practice Address - City:CITRUS HEIGHTS
Practice Address - State:CA
Practice Address - Zip Code:95610-3027
Practice Address - Country:US
Practice Address - Phone:916-723-8282
Practice Address - Fax:916-723-8276
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-13
Last Update Date:2012-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA23771111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA45-5042361OtherEIN