Provider Demographics
NPI:1003101858
Name:AYAKO NAKANO CHIROPRACTIC, INC.
Entity Type:Organization
Organization Name:AYAKO NAKANO CHIROPRACTIC, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:AYAKO
Authorized Official - Middle Name:
Authorized Official - Last Name:NAKANO
Authorized Official - Suffix:
Authorized Official - Credentials:DC, LAC
Authorized Official - Phone:626-446-1221
Mailing Address - Street 1:115 E LIVE OAK AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:ARCADIA
Mailing Address - State:CA
Mailing Address - Zip Code:91006-5285
Mailing Address - Country:US
Mailing Address - Phone:626-446-1221
Mailing Address - Fax:626-446-1121
Practice Address - Street 1:115 E LIVE OAK AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:ARCADIA
Practice Address - State:CA
Practice Address - Zip Code:91006-5285
Practice Address - Country:US
Practice Address - Phone:626-446-1221
Practice Address - Fax:626-446-1121
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-09
Last Update Date:2011-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC29354111N00000X
CAAC11103171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty