Provider Demographics
NPI:1952534653
Name:LUK, KA BO JANIS (DC)
Entity Type:Individual
Prefix:DR
First Name:KA BO
Middle Name:JANIS
Last Name:LUK
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 1:2630 SAN GABRIEL BLVD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:ROSEMEAD
Mailing Address - State:CA
Mailing Address - Zip Code:91770-5204
Mailing Address - Country:US
Mailing Address - Phone:626-280-9968
Mailing Address - Fax:877-400-0565
Practice Address - Street 1:2630 SAN GABRIEL BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:ROSEMEAD
Practice Address - State:CA
Practice Address - Zip Code:91770-5204
Practice Address - Country:US
Practice Address - Phone:626-280-9968
Practice Address - Fax:877-400-0565
Is Sole Proprietor?:No
Enumeration Date:2009-08-27
Last Update Date:2009-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA31375111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAD9149703OtherDRIVER LICENSE