Provider Demographics
NPI:1447410303
Name:MACHIMURA, NAOMI (LAC)
Entity Type:Individual
Prefix:MS
First Name:NAOMI
Middle Name:
Last Name:MACHIMURA
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27 NIGHTINGALE DR
Mailing Address - Street 2:
Mailing Address - City:ALISO VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92656-1706
Mailing Address - Country:US
Mailing Address - Phone:714-865-7504
Mailing Address - Fax:
Practice Address - Street 1:4482 BARRANCA PKWY STE 248
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92604-4770
Practice Address - Country:US
Practice Address - Phone:714-865-7504
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-13
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC11673171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist