Healthcare Provider Details

I. General information

NPI: 1255185039
Provider Name (Legal Business Name): RACHEL ANN NAKAMOTO DC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/16/2024
Last Update Date: 04/16/2024
Certification Date: 04/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11911 ARTESIA BLVD STE 102
CERRITOS CA
90701-4060
US

IV. Provider business mailing address

11911 ARTESIA BLVD STE 102
CERRITOS CA
90701-4060
US

V. Phone/Fax

Practice location:
  • Phone: 562-809-3112
  • Fax: 562-809-3139
Mailing address:
  • Phone: 562-809-3112
  • Fax: 562-809-3139

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License NumberDC36880
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: