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General NPI Number Information
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NPI Number | 1447764154
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Entity Type | Organization
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Legal Business Name | JAPANESE HEALING INC
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Dates
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Enumeration Date | 11/17/2017
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Last Update Date | 11/17/2017
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Provider Practice Location Address
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Address Line | 11340 W OLYMPIC BLVD STE 340
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City | LOS ANGELES
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State | CA
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Zip | 90064-1613
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Country | US
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Telephone | 310-991-0729
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Fax | 424-203-3005
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Provider Business Mailing Address
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Address Line | 11340 W. OLYMPIC BLVD SUITE 340
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City | LOS ANGELES
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State | CA
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Zip | 90064-1613
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Country | US
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Telephone | 310-991-0729
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Fax | 424-203-3005
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. TAKESHI KOMATSU
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Credential | DAOM ATC LAC
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Telephone | 310-991-0729
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 7799
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License Number State | CA
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