Healthcare Provider Details

I. General information

NPI: 1013828839
Provider Name (Legal Business Name): RYOTA FUJII DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2026
Last Update Date: 09/14/2026
Certification Date: 09/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

640 S SAN VICENTE BLVD STE 266
LOS ANGELES CA
90048-4665
US

IV. Provider business mailing address

640 S SAN VICENTE BLVD STE 266
LOS ANGELES CA
90048-4665
US

V. Phone/Fax

Practice location:
  • Phone: 424-235-6005
  • Fax:
Mailing address:
  • Phone: 424-235-6005
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number35092
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: