Provider Demographics
NPI:1184820730
Name:KAWAHARADA, JOHN KAZUTO (DC)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:KAZUTO
Last Name:KAWAHARADA
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 1:7981 HOLLYWOOD BLVD
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90046-2611
Mailing Address - Country:US
Mailing Address - Phone:323-896-4664
Mailing Address - Fax:
Practice Address - Street 1:960 E GREEN ST
Practice Address - Street 2:SUITE L-3
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91106-2401
Practice Address - Country:US
Practice Address - Phone:626-698-0655
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA29873111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor