Organization
THOMAS J, TANAKA, DPM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS TANAKA (OWNER)
(714) 832-7212
Entity
Organization
Contact information
Practice address
17400 IRVINE BLVD, SUITE H, TUSTIN, CA 92780-3030
(714) 832-7212
Mailing address
17400 IRVINE BLVD, SUITE H, TUSTIN, CA 92780-3030
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
E3648
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000E36480
—
CA
Enumeration date
09/17/2006
Last updated
03/12/2008
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