Provider Demographics
NPI:1740359124
Name:LIFSCHITZ, SCOTT (DC)
Entity type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:
Last Name:LIFSCHITZ
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 1:569 WALTER AVE
Mailing Address - Street 2:
Mailing Address - City:NEWBURY PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91320-5069
Mailing Address - Country:US
Mailing Address - Phone:562-587-2567
Mailing Address - Fax:
Practice Address - Street 1:2060 E AVENIDA DE LOS ARBOLES STE H
Practice Address - Street 2:
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91362-6139
Practice Address - Country:US
Practice Address - Phone:805-492-1500
Practice Address - Fax:805-492-1504
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-07
Last Update Date:2008-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC24162111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician