Provider Demographics
NPI:1588740807
Name:OKAZAKI, MICHIHIRO (DC)
Entity type:Individual
Prefix:DR
First Name:MICHIHIRO
Middle Name:
Last Name:OKAZAKI
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 1:8665 GIBBS DR
Mailing Address - Street 2:SUITE 140
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92123-1747
Mailing Address - Country:US
Mailing Address - Phone:858-514-8320
Mailing Address - Fax:858-514-8340
Practice Address - Street 1:8665 GIBBS DR
Practice Address - Street 2:SUITE 140
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123-1747
Practice Address - Country:US
Practice Address - Phone:858-514-8320
Practice Address - Fax:858-514-8340
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-29
Last Update Date:2015-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC26231111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC26231Medicare UPIN
CAVO1558Medicare UPIN