Provider Demographics
NPI:1730349127
Name:TANAKA, STEVEN TOSHIO (DC)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:TOSHIO
Last Name:TANAKA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 PROSPECT ST
Mailing Address - Street 2:
Mailing Address - City:WATSONVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95076-3219
Mailing Address - Country:US
Mailing Address - Phone:831-728-4233
Mailing Address - Fax:831-728-4233
Practice Address - Street 1:101 PROSPECT ST
Practice Address - Street 2:
Practice Address - City:WATSONVILLE
Practice Address - State:CA
Practice Address - Zip Code:95076-3219
Practice Address - Country:US
Practice Address - Phone:831-728-4233
Practice Address - Fax:831-728-4233
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-10
Last Update Date:2008-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA11383111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor