Provider Demographics
NPI:1073772992
Name:YOSHIDA, TOSHIHIDE (DC)
Entity Type:Individual
Prefix:
First Name:TOSHIHIDE
Middle Name:
Last Name:YOSHIDA
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 1:3300 BASS LAKE RD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:BROOKLYN CENTER
Mailing Address - State:MN
Mailing Address - Zip Code:55429-3065
Mailing Address - Country:US
Mailing Address - Phone:763-560-0187
Mailing Address - Fax:651-771-7382
Practice Address - Street 1:3300 BASS LAKE RD
Practice Address - Street 2:SUITE 202
Practice Address - City:BROOKLYN CENTER
Practice Address - State:MN
Practice Address - Zip Code:55429-3065
Practice Address - Country:US
Practice Address - Phone:763-560-0187
Practice Address - Fax:651-771-7382
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-05
Last Update Date:2008-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN4149111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor