Healthcare Provider Details

I. General information

NPI: 1891605341
Provider Name (Legal Business Name): FLOYD HARIRASM POOSWAN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/08/2026
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5474 WILSHIRE BLVD
LOS ANGELES CA
90036-4218
US

IV. Provider business mailing address

3500 ELM AVE UNIT 9
LONG BEACH CA
90807-3920
US

V. Phone/Fax

Practice location:
  • Phone: 323-634-0835
  • Fax:
Mailing address:
  • Phone: 714-408-3510
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number91503
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: