Individual provider · Type 1 NPI

Gen Tanaka, MD

Student in an Organized Health Care Education/Training Program · Brockton, MA

NPI number 1245511765 Active

Practice location

940 Belmont St, Psychiatry 116A7
Brockton, MA 02301-5596

Call (774) 826-2458 Map

Mailing address

75 Donald St, Apt 58
Weymouth, MA 02188-3962

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000X248497 (MA)

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1245511765

Gen Tanaka, MD's National Provider Identifier is 1245511765, issued on Aug 30, 2011. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Brockton, MA. The record was last updated on Aug 30, 2011.