Individual
MR. DARRYL TAD TANAKA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OTR/L
Contact information
Practice address
12051 CHAUCER RD, LOS ALAMITOS, CA 90720-4531
(562) 596-3668
Mailing address
12051 CHAUCER RD, LOS ALAMITOS, CA 90720-4531
(562) 596-3668
Taxonomy
Speciality
Code
Description
License number
State
225XE0001X
Environmental Modification Occupational Therapist
Primary
OT 6588
CA
Other
Enumeration date
04/21/2009
Last updated
04/21/2009
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