=====================================================
General NPI Number Information
=====================================================
NPI Number | 1841360757
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | CAROLE KOCHI D.C.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/08/2006
-----------------------------------------------------
Last Update Date | 08/24/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 11747 SOUTH ST
-----------------------------------------------------
City | ARTESIA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90701-6604
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 562-860-3738
-----------------------------------------------------
Fax | 562-860-9786
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 15550 ROCKFIELD BLVD B220
-----------------------------------------------------
City | IRVINE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92618-2720
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 949-598-9999
-----------------------------------------------------
Fax | 949-598-9990
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number | 20260
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------