Provider Demographics
NPI:1578526455
Name:TANAKA, TOSHIYUKI (MD)
Entity Type:Individual
Prefix:DR
First Name:TOSHIYUKI
Middle Name:
Last Name:TANAKA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3475 TORRANCE BLVD
Mailing Address - Street 2:SUITE C
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90503-5800
Mailing Address - Country:US
Mailing Address - Phone:310-792-9337
Mailing Address - Fax:310-792-8145
Practice Address - Street 1:3475 TORRANCE BLVD
Practice Address - Street 2:SUITE C
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90503-5800
Practice Address - Country:US
Practice Address - Phone:310-792-9337
Practice Address - Fax:310-792-8145
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-10
Last Update Date:2010-07-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG31637207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine