Healthcare Provider Details

I. General information

NPI: 1629101399
Provider Name (Legal Business Name): SUSAN LEILANI OYAKAWA D.C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/13/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1364 VALENCIA ST
SAN FRANCISCO CA
94110-3715
US

IV. Provider business mailing address

1364 VALENCIA ST
SAN FRANCISCO CA
94110-3715
US

V. Phone/Fax

Practice location:
  • Phone: 415-648-3327
  • Fax: 415-648-3171
Mailing address:
  • Phone: 415-648-3327
  • Fax: 415-648-3171

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NN1001X
TaxonomyNutrition Chiropractor
License Number24191
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: