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General NPI Number Information
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NPI Number | 1831217041
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Entity Type | Individual
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Provider Name | MILES WATANABE D.C., L.AC.
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Gender | Male
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Dates
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Enumeration Date | 03/26/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 1045 W REDONDO BEACH BLVD STE 575
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City | GARDENA
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State | CA
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Zip | 90247-4191
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Country | US
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Telephone | 310-523-2700
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Fax |
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Provider Business Mailing Address
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Address Line | 2058 JOHNSON CT
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City | TORRANCE
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State | CA
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Zip | 90504-2232
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Country | US
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Telephone | 310-748-3276
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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 | DC18997
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | AC3964
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License Number State | CA
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