Provider Demographics
NPI:1619930542
Name:KURANAKA, TRACY R (MD)
Entity Type:Individual
Prefix:MISS
First Name:TRACY
Middle Name:R
Last Name:KURANAKA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:4225 EXECUTIVE SQUARE
Mailing Address - Street 2:#1130
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92037
Mailing Address - Country:US
Mailing Address - Phone:858-455-9712
Mailing Address - Fax:858-655-9703
Practice Address - Street 1:4225 EXECUTIVE SQUARE
Practice Address - Street 2:#1130
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92037
Practice Address - Country:US
Practice Address - Phone:858-455-9712
Practice Address - Fax:858-655-9703
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA751702084P0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0802XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction Psychiatry