Individual
ALISA TANAKIT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
501 J ST, SACRAMENTO, CA 95814-2325
(497) 300-0916
Mailing address
41706 MARIGOLD DR, FREMONT, CA 94539-4779
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
331985
LA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1285165613
NPI
LA
Enumeration date
03/27/2017
Last updated
10/16/2024
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