Provider Demographics
NPI:1205869757
Name:SHUTO, CHIKA (L AC)
Entity type:Individual
Prefix:DR
First Name:CHIKA
Middle Name:
Last Name:SHUTO
Suffix:
Gender:F
Credentials:L AC
Other - Prefix:DR
Other - First Name:CHIKA
Other - Middle Name:
Other - Last Name:SHUTO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:L AC
Mailing Address - Street 1:100 TECHNOLOGY DR
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-2401
Mailing Address - Country:US
Mailing Address - Phone:949-306-6288
Mailing Address - Fax:
Practice Address - Street 1:100 TECHNOLOGY DRIVE
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618
Practice Address - Country:US
Practice Address - Phone:949-306-6288
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-08
Last Update Date:2013-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC 11088171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist