Provider Demographics
NPI:1417231564
Name:UCHIDA ACUPUNCTURE INC A PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:UCHIDA ACUPUNCTURE INC A PROFESSIONAL CORPORATION
Other - Org Name:UCHIDA ACUPUNCTURE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:UCHIDA
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:310-430-6267
Mailing Address - Street 1:5839 GREEN VALLEY CIR
Mailing Address - Street 2:SUITE 201
Mailing Address - City:CULVER CITY
Mailing Address - State:CA
Mailing Address - Zip Code:90230-6937
Mailing Address - Country:US
Mailing Address - Phone:424-543-6775
Mailing Address - Fax:424-543-6776
Practice Address - Street 1:5839 GREEN VALLEY CIR
Practice Address - Street 2:SUITE 201
Practice Address - City:CULVER CITY
Practice Address - State:CA
Practice Address - Zip Code:90230-6937
Practice Address - Country:US
Practice Address - Phone:424-543-6775
Practice Address - Fax:424-543-6776
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-07
Last Update Date:2013-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC7970171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA201058300OtherACS FECA