Provider Demographics
NPI:1619097649
Name:NAKAJIMA, MIKIKO AOYAGI (ATC)
Entity Type:Individual
Prefix:DR
First Name:MIKIKO
Middle Name:AOYAGI
Last Name:NAKAJIMA
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:DR
Other - First Name:MIMI
Other - Middle Name:
Other - Last Name:NAKAJIMA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:ATC
Mailing Address - Street 1:5581 E ROLANDA ST
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90815-2038
Mailing Address - Country:US
Mailing Address - Phone:562-889-2798
Mailing Address - Fax:
Practice Address - Street 1:1250 N BELLFLOWER BLVD
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90840-4901
Practice Address - Country:US
Practice Address - Phone:562-985-8011
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-31
Last Update Date:2014-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer