Provider Demographics
NPI:1366714248
Name:UY, SENKOSAL H (DC)
Entity type:Individual
Prefix:DR
First Name:SENKOSAL
Middle Name:H
Last Name:UY
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 1:4067 HARDWICK ST
Mailing Address - Street 2:#123
Mailing Address - City:LAKEWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90712-2350
Mailing Address - Country:US
Mailing Address - Phone:714-768-3173
Mailing Address - Fax:
Practice Address - Street 1:18300 GRIDLEY RD
Practice Address - Street 2:#303
Practice Address - City:ARTESIA
Practice Address - State:CA
Practice Address - Zip Code:90701-5440
Practice Address - Country:US
Practice Address - Phone:562-999-2829
Practice Address - Fax:562-865-6999
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-07
Last Update Date:2016-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA32005111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor