Provider Demographics
NPI:1992928014
Name:OKUYAMA, MUNEAKI (LAC,PHD)
Entity type:Individual
Prefix:DR
First Name:MUNEAKI
Middle Name:
Last Name:OKUYAMA
Suffix:
Gender:M
Credentials:LAC,PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2505 DESCANSO WAY
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90504-3526
Mailing Address - Country:US
Mailing Address - Phone:310-217-8800
Mailing Address - Fax:310-217-8833
Practice Address - Street 1:2505 DESCANSO WAY
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90504-3526
Practice Address - Country:US
Practice Address - Phone:310-217-8800
Practice Address - Fax:310-217-8833
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC.1005171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist