Provider Demographics
NPI:1912617838
Name:RASCON, LUCAS GENE (DC)
Entity Type:Individual
Prefix:
First Name:LUCAS
Middle Name:GENE
Last Name:RASCON
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 1:690 ARUNDEL RD
Mailing Address - Street 2:
Mailing Address - City:GOLETA
Mailing Address - State:CA
Mailing Address - Zip Code:93117-2160
Mailing Address - Country:US
Mailing Address - Phone:805-455-0627
Mailing Address - Fax:
Practice Address - Street 1:690 ARUNDEL RD
Practice Address - Street 2:
Practice Address - City:GOLETA
Practice Address - State:CA
Practice Address - Zip Code:93117-2160
Practice Address - Country:US
Practice Address - Phone:805-455-0627
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-01
Last Update Date:2022-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA36469111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor