Provider Demographics
NPI:1467505164
Name:MITSUO YANAGIHARA, D.C., INC.
Entity Type:Organization
Organization Name:MITSUO YANAGIHARA, D.C., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MITSUO
Authorized Official - Middle Name:
Authorized Official - Last Name:YANAGIHARA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:323-569-2727
Mailing Address - Street 1:10133 ATLANTIC AVE
Mailing Address - Street 2:
Mailing Address - City:SOUTH GATE
Mailing Address - State:CA
Mailing Address - Zip Code:90280-6452
Mailing Address - Country:US
Mailing Address - Phone:323-569-2727
Mailing Address - Fax:323-569-5931
Practice Address - Street 1:10133 ATLANTIC AVE
Practice Address - Street 2:
Practice Address - City:SOUTH GATE
Practice Address - State:CA
Practice Address - Zip Code:90280-6452
Practice Address - Country:US
Practice Address - Phone:323-569-2727
Practice Address - Fax:323-569-5931
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-18
Last Update Date:2007-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC9080111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC9080Medicare ID - Type Unspecified