Healthcare Provider Details

I. General information

NPI: 1942448311
Provider Name (Legal Business Name): NAOKI KAMOSHIDA DC LAC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/23/2009
Last Update Date: 08/03/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1366 W 7TH ST SUITE 4B
SAN PEDRO CA
90732-3500
US

IV. Provider business mailing address

1366 W 7TH ST SUITE 4B
SAN PEDRO CA
90732-3500
US

V. Phone/Fax

Practice location:
  • Phone: 310-547-2197
  • Fax: 310-547-9532
Mailing address:
  • Phone: 310-547-2197
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC 27614
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC 10053
License Number StateCA

VIII. Authorized Official

Name: DR. NAOKI KAMOSHIDA
Title or Position: PARTNER
Credential: DC LAC
Phone: 310-547-2197