Provider Demographics
NPI:1023259900
Name:ASAHARA, PAULINE KAZUMI (DC)
Entity type:Individual
Prefix:DR
First Name:PAULINE
Middle Name:KAZUMI
Last Name:ASAHARA
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 1:4410 24TH ST
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95822-1409
Mailing Address - Country:US
Mailing Address - Phone:916-455-0962
Mailing Address - Fax:916-455-0962
Practice Address - Street 1:4410 24TH ST
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95822-1409
Practice Address - Country:US
Practice Address - Phone:916-455-0962
Practice Address - Fax:916-455-0962
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-23
Last Update Date:2009-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC29589111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor