Provider Demographics
NPI:1073687828
Name:OKADA, SONNY HAYATO (DC)
Entity Type:Individual
Prefix:DR
First Name:SONNY
Middle Name:HAYATO
Last Name:OKADA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 W GONZALES RD STE 105
Mailing Address - Street 2:
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93036-3061
Mailing Address - Country:US
Mailing Address - Phone:805-988-1718
Mailing Address - Fax:805-988-9709
Practice Address - Street 1:1300 W GONZALES RD STE 105
Practice Address - Street 2:
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93036-3061
Practice Address - Country:US
Practice Address - Phone:805-988-1718
Practice Address - Fax:805-988-9709
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC18574111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor