Provider Demographics
NPI:1629393749
Name:KEHOE, YUKO (DC)
Entity Type:Individual
Prefix:DR
First Name:YUKO
Middle Name:
Last Name:KEHOE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24441 SILVER SPUR LN
Mailing Address - Street 2:
Mailing Address - City:LAGUNA NIGUEL
Mailing Address - State:CA
Mailing Address - Zip Code:92677-4090
Mailing Address - Country:US
Mailing Address - Phone:949-273-5149
Mailing Address - Fax:949-273-5149
Practice Address - Street 1:2383 LOMITA BLVD
Practice Address - Street 2:SUITE 111
Practice Address - City:LOMITA
Practice Address - State:CA
Practice Address - Zip Code:90717-1446
Practice Address - Country:US
Practice Address - Phone:310-530-8877
Practice Address - Fax:310-530-8827
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-31
Last Update Date:2010-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC31331111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor