Organization
LEO TANAKA MD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HIDEAKI L TANAKA MD (PRESIDENT-PHYSICIAN)
(425) 830-0884
Entity
Organization
Contact information
Practice address
5555 GROSSMONT CENTER DR, LA MESA, CA 91942-3019
(619) 740-6000
(619) 740-4380
Mailing address
9600 CUYAMACA ST STE 201, SANTEE, CA 92071-2692
(619) 258-6200
(619) 258-0028
Taxonomy
Speciality
Code
Description
License number
State
207PE0005X
Undersea and Hyperbaric Medicine (Emergency Medicine) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1124280730
—
CA
Enumeration date
07/14/2022
Last updated
07/19/2022
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