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Individual

DR. TED SATOSHI TANAKA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.P.M.

Contact information

Practice address
11362 SAN PABLO AVE, EL CERRITO, CA 94530-2135
(510) 233-4443
(510) 233-1337
Mailing address
11362 SAN PABLO AVE, EL CERRITO, CA 94530-2135
(510) 233-4443
(510) 233-1337

Taxonomy

Speciality
Code
Description
License number
State
213ES0131X
Foot Surgery Podiatrist
Primary
E3450
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000E34500
MEDICARE
Enumeration date
12/22/2005
Last updated
06/11/2008
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