Provider Demographics
NPI:1750314167
Name:HUTNICK, LANA S (DC)
Entity type:Individual
Prefix:
First Name:LANA
Middle Name:S
Last Name:HUTNICK
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 N ABEL ST
Mailing Address - Street 2:
Mailing Address - City:MILPITAS
Mailing Address - State:CA
Mailing Address - Zip Code:95035-4833
Mailing Address - Country:US
Mailing Address - Phone:408-262-4135
Mailing Address - Fax:408-262-1379
Practice Address - Street 1:8 N ABEL ST
Practice Address - Street 2:
Practice Address - City:MILPITAS
Practice Address - State:CA
Practice Address - Zip Code:95035-4833
Practice Address - Country:US
Practice Address - Phone:408-262-4135
Practice Address - Fax:408-262-1379
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA15522111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC0155220Medicare ID - Type UnspecifiedCHIROPRACTOR