Provider Demographics
NPI:1013103233
Name:HASEGAWA, YOICHI (LAC)
Entity Type:Individual
Prefix:
First Name:YOICHI
Middle Name:
Last Name:HASEGAWA
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:PO BOX 60967
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92602-6032
Mailing Address - Country:US
Mailing Address - Phone:310-999-9007
Mailing Address - Fax:
Practice Address - Street 1:31461 RANCHO VIEJO RD
Practice Address - Street 2:SUITE 104
Practice Address - City:SAN JUAN CAPISTRANO
Practice Address - State:CA
Practice Address - Zip Code:92675-1864
Practice Address - Country:US
Practice Address - Phone:949-218-4141
Practice Address - Fax:949-218-4242
Is Sole Proprietor?:No
Enumeration Date:2007-09-20
Last Update Date:2008-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC7028171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist