Provider Demographics
NPI:1508221698
Name:YOSHIDA, SATOKO
Entity Type:Individual
Prefix:
First Name:SATOKO
Middle Name:
Last Name:YOSHIDA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12327 GREENE AVE
Mailing Address - Street 2:UNIT 9
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90066-6285
Mailing Address - Country:US
Mailing Address - Phone:323-828-8968
Mailing Address - Fax:
Practice Address - Street 1:12327 GREENE AVE
Practice Address - Street 2:UNIT 9
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90066-6285
Practice Address - Country:US
Practice Address - Phone:323-828-8968
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-16
Last Update Date:2015-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC16903171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist