Individual
DR. LAINE WATANABE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
450 BROADWAY ST, MC 6342, REDWOOD CITY, CA 94063-3132
(650) 721-7627
Mailing address
450 BROADWAY ST, MC 6342, REDWOOD CITY, CA 94063-3132
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
A 109773
CA
Other
Enumeration date
02/02/2010
Last updated
02/02/2010
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