Individual
KOUICHI TANAKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1000 W CARSON ST, BOX 480, TORRANCE, CA 90502-2004
(310) 222-3695
Mailing address
1000 W CARSON ST, BOX 480, TORRANCE, CA 90502-2004
(310) 222-3695
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
A20035
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A152050
—
CA
Enumeration date
01/22/2007
Last updated
07/09/2007
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