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General NPI Number Information
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NPI Number | 1659638369
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Entity Type | Individual
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Provider Name | HIRONARI KOYAMA D.C.
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Gender | Male
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Dates
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Enumeration Date | 04/19/2012
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Last Update Date | 08/05/2021
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Provider Practice Location Address
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Address Line | 12629 W WASHINGTON BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90066-2303
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Country | US
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Telephone | 310-391-6125
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Fax |
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Provider Business Mailing Address
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Address Line | 24828 OAK ST APT 6
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City | LOMITA
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State | CA
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Zip | 90717-1622
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Country | US
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Telephone | 310-691-4172
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | DC31898
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License Number State | CA
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