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General NPI Number Information
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NPI Number | 1740211895
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Entity Type | Individual
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Provider Name | STEPHEN MITSURU ITO D.C.
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Gender | Male
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Dates
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Enumeration Date | 07/06/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 39525 LOS ALAMOS RD SUITE E
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City | MURRIETA
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State | CA
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Zip | 92563-5027
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Country | US
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Telephone | 951-698-4032
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Fax | 951-698-1132
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Provider Business Mailing Address
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Address Line | 29280 MOON HILL CT
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City | MENIFEE
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State | CA
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Zip | 92584-7315
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Country | US
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Telephone | 951-679-7874
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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 | 21375
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License Number State | CA
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