Individual
ROBERT M TANAKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
600 COFFEE RD, MODESTO, CA 95355-4201
(209) 524-1211
Mailing address
600 COFFEE RD, MODESTO, CA 95355-4201
(209) 524-1211
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
G35094
CA
207RP1001X
Pulmonary Disease Physician
Primary
G35094
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G350940
—
CA
Enumeration date
06/06/2006
Last updated
02/10/2011
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