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General NPI Number Information
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NPI Number | 1700763109
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Entity Type | Organization
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Legal Business Name | 5 SURF CORPORATION
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Dates
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Enumeration Date | 08/18/2025
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Last Update Date | 08/30/2025
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Provider Practice Location Address
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Address Line | 18821 DELAWARE ST
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City | HUNTINGTON BEACH
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State | CA
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Zip | 92648-1926
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Country | US
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Telephone | 714-625-8762
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Fax |
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Provider Business Mailing Address
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Address Line | 6071 E LOS ARCOS ST
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City | LONG BEACH
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State | CA
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Zip | 90815-2122
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Country | US
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Telephone | 562-357-3595
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | BRIAN YOSHIOKA
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Credential | LAC
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Telephone | 562-357-3595
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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