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Gen Tanaka, MD
Student in an Organized Health Care Education/Training Program in Brockton, Massachusetts
NPI 1245511765

Gen Tanaka is a Student in an Organized Health Care Education/Training Program based in Weymouth, MA. Gen Tanaka practices in Brockton, MA and has the professional credentials of MD. The NPI Number for Gen Tanaka is 1245511765 and holds a License No. 248497 (Massachusetts).

The current practice location address for Gen Tanaka is 940 Belmont St, Brockton, MA and can be reached out via phone at 774-826-2458.

Location: 940 Belmont St, Brockton, MA, 02188-3962
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1245511765
Provider Name
Gen Tanaka
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
940 Belmont St, Brockton, MA, 02188-3962
Phone Number
774-826-2458
Fax Number
Provider Enumeration Date
08/30/2011
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
940 Belmont St
City
Brockton
State
Massachusetts
Zip
02301-5596
Phone Number
774-826-2458
Fax Number
person
Provider Business Mailing Address Details
Address
940 Belmont St
City
Brockton
State
Massachusetts
Zip
02301-5596
Phone Number
774-826-2458
Fax Number
person
Provider's Taxonomy Details 1
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
248497 (Massachusetts)
Definition
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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