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Organization
MIKIO TACHIBANA, M.D., INC
Active
Organization
MIKIO TACHIBANA, M.D., INC
Active
Other names
MIKIO TACHIBANA, M.D.
Organization subpart
No
Provider details
NPI number
Authorized official
MIKIO TACHIBANA M.D. (PRESIDENT)
(714) 966-2800
Entity
Organization
Contact information
Practice address
11100 WARNER AVE, SUITE 154, FOUNTAIN VALLEY, CA 92708-7506
(714) 966-2800
(714) 966-0421
Mailing address
11100 WARNER AVE, SUITE 154, FOUNTAIN VALLEY, CA 92708-7506
(714) 966-2800
(714) 966-0421
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
A35433
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A354330
—
CA
Enumeration date
09/07/2007
Last updated
09/07/2007
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