Individual
DR. JENINE LUCILLE TANABE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
414 G ST STE 204, MARYSVILLE, CA 95901-5669
(530) 743-0301
(530) 743-2241
Mailing address
414 G ST STE 204, MARYSVILLE, CA 95901-5669
(530) 743-0301
(530) 743-2241
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
G47810
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G478101
—
CA
Enumeration date
09/13/2006
Last updated
07/08/2007
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