Individual
DR. SCOTT KIYOSHI TANAKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4060 4TH AVE STE 700, SAN DIEGO, CA 92103-2121
(619) 299-8500
(619) 299-3370
Mailing address
4060 4TH AVE STE 700, SAN DIEGO, CA 92103-2121
(619) 299-8500
(619) 299-3370
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
002983
CA
207X00000X
Orthopaedic Surgery Physician
A129847
CA
207XS0106X
Orthopaedic Hand Surgery Physician
Primary
A129847
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A129847
CA LICENSE
CA
Enumeration date
09/12/2008
Last updated
04/24/2026
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