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:
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Health care specialties

SpecialtyCodeLicense #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 19 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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Identifiers

StateTypeNumberIssuer
All States NPI 1922159466 NPPES
California MEDICAID GR0079700
California MEDICAID 00SP18300

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