Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0700X | Prosthodontist | 46332 | CA |
NPI | 1235288432 |
---|---|
Provider Name | Dr. Elaine Tamiko |
First Address | Anaheim, CA 92804-5314 |
Second Address | Anaheim, CA 92804-5314 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/01/2007 |
Last Update Date | 28/06/2010 |