Individual provider Active NPI

Daniel Lukenchuk, DC

  • Sports Physician Chiropractor
  • San Clemente, CA
National Provider Identifier
1346130630
Registry record updated Jul 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Physician ChiropractorTaxonomy code 111NS0005X
License
DC3712 Issued in CA
Practice address
629 Camino de Los Mares Ste 104
San Clemente, CA 92673-2829
Phone
(949) 240-1334
NPI assigned
Jul 8, 2025
Last updated
Jul 8, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Physician Chiropractor 111NS0005X DC3712 CA Primary

Addresses

Primary practice location

629 Camino de Los Mares Ste 104
San Clemente, CA 92673-2829

Mailing address

629 Camino de Los Mares Ste 104
San Clemente, CA 92673-2829
Phone (949) 240-1334

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DC3712CAMDSports Physician Chiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Russell Thompson Chiropractic Inc CurrentSince Jul 13, 2025 Accepting new patients

Locations

629 Camino de los Mares
Ste 104
San Clemente, CA 92673
Phone (714) 240-1334

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1751932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751932800000",
    "number": "1346130630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "629 CAMINO DE LOS MARES STE 104",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926732829",
            "telephone_number": "949-240-1334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "629 CAMINO DE LOS MARES STE 104",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926732829",
            "telephone_number": "949-240-1334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUKENCHUK",
        "first_name": "DANIEL",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-07-08",
        "last_updated": "2025-07-08",
        "certification_date": "2025-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "CA",
            "license": "DC3712",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Clemente, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.