Provider Demographics
NPI:1912024019
Name:OZAKI, KATSUHIRO (LAC)
Entity Type:Individual
Prefix:MR
First Name:KATSUHIRO
Middle Name:
Last Name:OZAKI
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2550 E AMAR RD
Mailing Address - Street 2:#A-1B
Mailing Address - City:WEST COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91792-2230
Mailing Address - Country:US
Mailing Address - Phone:626-810-5300
Mailing Address - Fax:
Practice Address - Street 1:2550 E AMAR RD
Practice Address - Street 2:#A-1B
Practice Address - City:WEST COVINA
Practice Address - State:CA
Practice Address - Zip Code:91792-2230
Practice Address - Country:US
Practice Address - Phone:626-810-5300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC3995171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist