Tanaka, Mamoru

Tanaka, Mamoru is an sole proprietor health care provider with primary practice located at 8008 Frost St # 800 , San Diego CA 92123-4205. He recently has only one registered license in Dental Providers / Prosthodontics, which is considered as his primary health care specialty. Tanaka, Mamoru can be contacted via phone (617) 459-9491.

Contact Information

Primary practice address
8008 Frost St # 800 San Diego CA 92123-4205
Phone: (617) 459-9491
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Prosthodontics 1223P0700X 101517 California
Dental Providers / Prosthodontics 1223P0700X 31503 Texas

Profile Details

NPI number 1265717391
LBN Legal business name Tanaka, Mamoru
Credentials D.D.S, FACP
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 20th, 2011
Last updated Nov 22nd, 2022 - about 2 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.

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