Ryota Justin Aizawa, DC
Individual provider Active NPI Chiropractor · Fremont, CA
NPI 1487498366 · NPPES record last updated Dec 2, 2024
Key facts
- NPI
- 1487498366
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 36976 (CA)
- Practice address
- 2140 Peralta Blvd Ste 102
Fremont, CA 94536-3959 - Phone
- (510) 936-2631
- Fax
- (510) 902-7808
- NPI assigned
- Jun 24, 2024
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 36976 | CA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Aizawa Chiropractic | Chiropractor | Current |
Accepting new patients |
Locations
2140 Peralta Blvd
Ste 102
Fremont, CA 94536
Phone (510) 936-2631
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 36976 | CA | Yes |
Addresses
Primary practice location
2140 Peralta Blvd Ste 102
Fremont, CA 94536-3959
Mailing address
2140 Peralta Blvd Ste 102
Fremont, CA 94536-3959
Phone (510) 936-2631
Other providers in Fremont, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 2, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.