Individual
JARRETT TANAKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CPO
Contact information
Practice address
23451 MADISON ST STE 200, TORRANCE, CA 90505-4760
(310) 977-6013
Mailing address
23451 MADISON ST #200, TORRANCE, CA 90505
(310) 977-6013
Taxonomy
Speciality
Code
Description
License number
State
222Z00000X
Orthotist
Primary
CPO03810
DE
224P00000X
Prosthetist
CPO03810
DE
Other
Enumeration date
05/22/2018
Last updated
05/22/2018
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