Individual
THOMAS JIN TANAKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
2295 S VINEYARD AVE, BLDG. D, ONTARIO, CA 91761-7925
(909) 724-5052
(714) 832-0554
Mailing address
2295 S VINEYARD AVE, BLDG. D, ONTARIO, CA 91761-7925
(714) 832-7212
(714) 832-0554
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
12/19/2006
Last updated
11/30/2021
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