Provider Demographics
NPI:1710057690
Name:LAMBERT, EVAN DEAN (DC)
Entity Type:Individual
Prefix:DR
First Name:EVAN
Middle Name:DEAN
Last Name:LAMBERT
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 1:5000 VAN NUYS BLVD
Mailing Address - Street 2:STE 110
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91403-1717
Mailing Address - Country:US
Mailing Address - Phone:661-260-0873
Mailing Address - Fax:661-260-1629
Practice Address - Street 1:23502 LYONS AVE
Practice Address - Street 2:SUITE 202A
Practice Address - City:SANTA CLARITA
Practice Address - State:CA
Practice Address - Zip Code:91321-2535
Practice Address - Country:US
Practice Address - Phone:661-260-0873
Practice Address - Fax:661-260-1629
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-08
Last Update Date:2017-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC25345111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician