Tanaka, Diane Kimiko
Tanaka, Diane Kimiko is an individual health care provider with primary practice located at 4650 W Sunset Blvd Ms# 2, Los Angeles CA 90027-6062. She recently has only one registered license in Allopathic & Osteopathic Physicians / Adolescent Medicine, which is considered as her primary health care specialty. Tanaka, Diane Kimiko can be contacted via phone (323) 669-2153.Contact Information
Primary practice address
4650 W Sunset Blvd Ms# 2
Los Angeles CA 90027-6062
Phone: (323) 669-2153
Fax: (323) 913-3691
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Adolescent Medicine | 2080A0000X | G73061 | California |
Profile Details
| NPI number | 1861588626 |
|---|---|
| LBN Legal business name | Tanaka, Diane Kimiko |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 5th, 2006 |
| Last updated | Aug 15th, 2011 - about 13 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1861588626 | NPPES |
| California | MEDICAID | 00G730610 |
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