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NPI Code Detail

MEDICARE: DR. THOMAS HENRY KANEGAE M.D.

MEDICARE:  DR. THOMAS HENRY KANEGAE  M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine PhysicianG25710CA

General Provider Information

NPI Number : 1902805914
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. THOMAS HENRY KANEGAE M.D.
Provider Business Mailing Address
First Line : 1245 WILSHIRE BLVD
Second Line : #804
City : LOS ANGELES
State : CA
Zip : 90017-4810
Country : US
Telephone Number : 213-977-1030
Fax Number : 213-977-0379
Provider Business Practice Location Address
First Line : 1245 WILSHIRE BLVD
Second Line : STE 804
City : LOS ANGELES
State : CA
Zip : 90017-4810
Country : US
Telephone Number : 213-977-1030
Fax Number : 213-977-0379
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/20/2005
Last Update Date : 12/08/2011

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Directions to “ DR. THOMAS HENRY KANEGAE M.D.” Practice Location

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