1659497931 NPI number — DR. DAWN NAOMI YOSHIOKA EBERLY D.C., L.AC

Table of content: DR. DAWN NAOMI YOSHIOKA EBERLY D.C., L.AC (NPI 1659497931)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1659497931 NPI number — DR. DAWN NAOMI YOSHIOKA EBERLY D.C., L.AC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
EBERLY
Provider First Name:
DAWN
Provider Middle Name:
NAOMI YOSHIOKA
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
D.C., L.AC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
YOSHIOKA
Provider Other First Name:
DAWN
Provider Other Middle Name:
NAOMI
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
D.C., L.AC
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1659497931
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/10/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
11901 SANTA MONICA BLVD
Provider Second Line Business Mailing Address:
#377
Provider Business Mailing Address City Name:
LOS ANGELES
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
90025-2767
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
310-892-9495
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2001 S BARRINGTON AVE
Provider Second Line Business Practice Location Address:
SUITE 312
Provider Business Practice Location Address City Name:
LOS ANGELES
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90025-5363
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
424-273-1210
Provider Business Practice Location Address Fax Number:
310-997-3530
Provider Enumeration Date:
03/21/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 111NS0005X , with the licence number:  DC30522 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 171100000X , with the licence number: AC 12570 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: AC 12570 . This is a "ACUPUNCTURIST" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: DC30522 . This is a "CHIROPRACTIC LICENSE" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".