Provider Demographics
NPI:1710390406
Name:LUKAS, BRETT (DC)
Entity Type:Individual
Prefix:DR
First Name:BRETT
Middle Name:
Last Name:LUKAS
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 1:17581 ROXANNE LN
Mailing Address - Street 2:UNIT B
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92647-8962
Mailing Address - Country:US
Mailing Address - Phone:949-209-7636
Mailing Address - Fax:
Practice Address - Street 1:2700 W COAST HWY STE 234
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92663-4728
Practice Address - Country:US
Practice Address - Phone:949-209-7636
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-10
Last Update Date:2014-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA32959111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor