Provider Demographics
NPI:1124165642
Name:NARUISHI, KOICHI (DC)
Entity type:Individual
Prefix:DR
First Name:KOICHI
Middle Name:
Last Name:NARUISHI
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 1:3286 ADELINE ST
Mailing Address - Street 2:SUITE 9
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94703-2483
Mailing Address - Country:US
Mailing Address - Phone:510-428-2332
Mailing Address - Fax:
Practice Address - Street 1:3286 ADELINE ST
Practice Address - Street 2:SUITE 9
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94703-2483
Practice Address - Country:US
Practice Address - Phone:510-428-2332
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA27271111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor