Basic Information
Provider Information
NPI: 1386062446
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: TANIMOTO
FirstName: AKI
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3333 BURNET AVE ML 5021
Address2:  
City: CINCINNATI
State: OH
PostalCode: 452293026
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 3333 BURNET AVE ML 5031
Address2:  
City: CINCINNATI
State: OH
PostalCode: 452293026
CountryCode: US
TelephoneNumber: 5136364251
FaxNumber: 5136368145
Other Information
ProviderEnumerationDate: 04/04/2014
LastUpdateDate: 01/14/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 01/14/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2085R0202XA163002CAN Allopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
2085P0229X35.143369OHY Allopathic & Osteopathic PhysiciansRadiologyPediatric Radiology

No ID Information.


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