Provider Demographics
NPI:1003970039
Name:SOWERS-MOKUAHI, LAURA T (DC)
Entity type:Individual
Prefix:DR
First Name:LAURA
Middle Name:T
Last Name:SOWERS-MOKUAHI
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:K
Other - Last Name:SOWERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:12409 RANCHO BERNARDO RD
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92128-2143
Mailing Address - Country:US
Mailing Address - Phone:858-485-8220
Mailing Address - Fax:858-485-8222
Practice Address - Street 1:12409 RANCHO BERNARDO RD
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92128-2143
Practice Address - Country:US
Practice Address - Phone:858-485-8220
Practice Address - Fax:858-485-8222
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-21
Last Update Date:2014-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC-27701111N00000X
AZ7689111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ117148Medicare PIN