Provider Demographics
NPI:1902434244
Name:TANAKA, ADAM CHING (MD, MPH, MS)
Entity type:Individual
Prefix:
First Name:ADAM
Middle Name:CHING
Last Name:TANAKA
Suffix:
Gender:M
Credentials:MD, MPH, MS
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Mailing Address - Street 1:5767 W CENTURY BLVD STE 400
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90045-5631
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:622 W DUARTE RD STE 101
Practice Address - Street 2:
Practice Address - City:ARCADIA
Practice Address - State:CA
Practice Address - Zip Code:91007-9266
Practice Address - Country:US
Practice Address - Phone:626-254-9010
Practice Address - Fax:626-254-9019
Is Sole Proprietor?:No
Enumeration Date:2020-03-31
Last Update Date:2024-07-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA194255207WX0009X, 207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No207WX0009XAllopathic & Osteopathic PhysiciansOphthalmologyGlaucoma Specialist