Provider Demographics
NPI:1881859098
Name:LUCAS, ANDREW CHIGNON JR (DC)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:CHIGNON
Last Name:LUCAS
Suffix:JR
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 1:5995 BROCKTON AVE
Mailing Address - Street 2:SUITE C1
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92506-1867
Mailing Address - Country:US
Mailing Address - Phone:951-778-0063
Mailing Address - Fax:
Practice Address - Street 1:5995 BROCKTON AVE
Practice Address - Street 2:SUITE C1
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92506-1867
Practice Address - Country:US
Practice Address - Phone:951-778-0063
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-28
Last Update Date:2008-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC20684111N00000X
WACH00003433111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor