Provider Demographics
NPI:1972517357
Name:AKIMOTO, ARTHUR MAMORU (DC)
Entity Type:Individual
Prefix:DR
First Name:ARTHUR
Middle Name:MAMORU
Last Name:AKIMOTO
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 1:712 E 1ST ST
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90012-4303
Mailing Address - Country:US
Mailing Address - Phone:213-617-9224
Mailing Address - Fax:213-617-8293
Practice Address - Street 1:712 E 1ST ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90012
Practice Address - Country:US
Practice Address - Phone:213-617-9224
Practice Address - Fax:213-617-8293
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-28
Last Update Date:2010-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC12591111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC12591Medicare PIN