Healthcare Provider Details

I. General information

NPI: 1164015285
Provider Name (Legal Business Name): NEW ERA CHIROPRACTIC MATSUMOTO INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/19/2021
Last Update Date: 02/19/2021
Certification Date: 02/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2750 E SPRING ST STE 250
LONG BEACH CA
90806-2283
US

IV. Provider business mailing address

2750 E SPRING ST STE 250
LONG BEACH CA
90806-2283
US

V. Phone/Fax

Practice location:
  • Phone: 562-283-3332
  • Fax: 310-683-5008
Mailing address:
  • Phone: 562-283-3332
  • Fax: 310-683-5008

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License Number
License Number State

VIII. Authorized Official

Name: DR. LEO MATSUMOTO
Title or Position: CEO/CHIROPRACTOR
Credential: DC
Phone: 562-283-3332