Tanaka, Wayne K.
Tanaka, Wayne K. is an individual health care provider with primary practice located at 11092 University Ct Rm 3306 , Loma Linda CA 92350-0001. He recently has only one registered license in Dental Providers / Oral and Maxillofacial Surgery, which is considered as his primary health care specialty. Tanaka, Wayne K. can be contacted via phone (909) 558-4671.Contact Information
Primary practice address
11092 University Ct Rm 3306
Loma Linda CA 92350-0001
Phone: (909) 558-4671
Fax: (909) 558-0285
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Oral and Maxillofacial Surgery | 1223S0112X | 51201 | California |
Profile Details
| NPI number | 1922159466 |
|---|---|
| LBN Legal business name | Tanaka, Wayne K. |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 12th, 2007 |
| Last updated | Jul 9th, 2007 - about 17 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 | 1922159466 | NPPES |
| California | MEDICAID | GR0079700 | |
| California | MEDICAID | 00SP18300 |
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