Individual
KATHERINE MARIKO TANAKA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
5512 E BRITTON DR STE 200, LONG BEACH, CA 90815-3149
(562) 421-2020
Mailing address
116 1ST ST, SEAL BEACH, CA 90740-6002
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
G58916
CA
Other
Enumeration date
06/15/2007
Last updated
07/08/2007
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