Provider Demographics
NPI:1821209008
Name:ACOBA, DWAYNE (DC)
Entity Type:Individual
Prefix:DR
First Name:DWAYNE
Middle Name:
Last Name:ACOBA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4430 E 14TH ST
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90804-3103
Mailing Address - Country:US
Mailing Address - Phone:562-261-3333
Mailing Address - Fax:866-323-6162
Practice Address - Street 1:4000 LONG BEACH BLVD
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90807-2617
Practice Address - Country:US
Practice Address - Phone:562-261-3333
Practice Address - Fax:866-323-6162
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC-26833111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor