Provider Demographics
NPI:1285723411
Name:TANAKA, H GEORGE (MD)
Entity type:Individual
Prefix:DR
First Name:H
Middle Name:GEORGE
Last Name:TANAKA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1515 SCOTT ST
Mailing Address - Street 2:SUITE 2
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94115
Mailing Address - Country:US
Mailing Address - Phone:415-771-4020
Mailing Address - Fax:415-771-4095
Practice Address - Street 1:1515 SCOTT ST
Practice Address - Street 2:SUITE 2
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115
Practice Address - Country:US
Practice Address - Phone:415-771-4020
Practice Address - Fax:415-771-4095
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2010-10-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG78526207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G785260Medicaid
CA00G785260Medicaid
CAZZZ06503ZMedicare UPIN
CAZZZ06704ZMedicare PIN
CAZZZ13185ZMedicare PIN