Provider Demographics
NPI:1942365093
Name:LUOMA, DIRK ERON (DC)
Entity Type:Individual
Prefix:
First Name:DIRK
Middle Name:ERON
Last Name:LUOMA
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 1:2300 MYRTLE AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:EUREKA
Mailing Address - State:CA
Mailing Address - Zip Code:95501-3328
Mailing Address - Country:US
Mailing Address - Phone:707-443-0695
Mailing Address - Fax:707-443-0778
Practice Address - Street 1:2300 MYRTLE AVE
Practice Address - Street 2:SUITE B
Practice Address - City:EUREKA
Practice Address - State:CA
Practice Address - Zip Code:95501-3328
Practice Address - Country:US
Practice Address - Phone:707-443-0695
Practice Address - Fax:707-443-0778
Is Sole Proprietor?:No
Enumeration Date:2006-12-27
Last Update Date:2016-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC0257480111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC0257480OtherCALIFORNIA STATE LICENSE
CAU77823Medicare UPIN