Provider Demographics
NPI:1881717213
Name:LUMIERE, TARAS (DC , LA,C)
Entity type:Individual
Prefix:
First Name:TARAS
Middle Name:
Last Name:LUMIERE
Suffix:
Gender:M
Credentials:DC , LA,C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2250 WOODSIDE LN
Mailing Address - Street 2:#1
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95825-7443
Mailing Address - Country:US
Mailing Address - Phone:916-761-1961
Mailing Address - Fax:916-489-1710
Practice Address - Street 1:3301 ALTA ARDEN EXPY
Practice Address - Street 2:SUITE 3
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95825-2121
Practice Address - Country:US
Practice Address - Phone:916-489-4400
Practice Address - Fax:916-489-1710
Is Sole Proprietor?:No
Enumeration Date:2007-04-09
Last Update Date:2013-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC15296111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAAC 2235OtherACUPUNTURE LICENSE #
CADC0152960Medicare ID - Type Unspecified