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General NPI Number Information
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NPI Number | 1790956043
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Entity Type | Organization
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Legal Business Name | THOMAS H KANEGAE M D A MEDICAL CORPORATION
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Dates
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Enumeration Date | 03/14/2008
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Last Update Date | 03/29/2011
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Provider Practice Location Address
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Address Line | 1245 WILSHIRE BLVD 804
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City | LOS ANGELES
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State | CA
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Zip | 90017-4810
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Country | US
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Telephone | 213-977-1030
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Fax | 213-977-0379
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Provider Business Mailing Address
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Address Line | 1245 WILSHIRE BLVD 804
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City | LOS ANGELES
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State | CA
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Zip | 90017-4810
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Country | US
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Telephone | 213-977-1030
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Fax | 213-977-0379
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Authorized Official
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Title or Position | OWNER
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Name | DR. THOMAS HENRY KANEGAE
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Credential | M D
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Telephone | 213-977-0913
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number |
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License Number State |
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