Provider Demographics
NPI:1154794717
Name:UEMURA, LEO (DC)
Entity type:Individual
Prefix:DR
First Name:LEO
Middle Name:
Last Name:UEMURA
Suffix:
Gender:
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21535 HAWTHORNE BLVD STE 270
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90503-6638
Mailing Address - Country:US
Mailing Address - Phone:424-201-0036
Mailing Address - Fax:
Practice Address - Street 1:6 E 39TH ST STE 203
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-0112
Practice Address - Country:US
Practice Address - Phone:332-529-1300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-04
Last Update Date:2025-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA31269111N00000X
NY013889111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty