Provider Demographics
NPI:1689901415
Name:MATSUMOTO, RONI YOSHIKO (DC)
Entity Type:Individual
Prefix:DR
First Name:RONI
Middle Name:YOSHIKO
Last Name:MATSUMOTO
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 1:4152 KATELLA AVE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:LOS ALAMITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90720-3441
Mailing Address - Country:US
Mailing Address - Phone:562-598-9609
Mailing Address - Fax:562-799-1462
Practice Address - Street 1:4152 KATELLA AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:LOS ALAMITOS
Practice Address - State:CA
Practice Address - Zip Code:90720-3441
Practice Address - Country:US
Practice Address - Phone:562-598-9609
Practice Address - Fax:562-799-1462
Is Sole Proprietor?:No
Enumeration Date:2009-11-16
Last Update Date:2009-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC31368111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor