Individual provider Active NPI

Kacey Bryce Tanabe

  • Obstetrics & Gynecology Physician
  • Monterey Park, CA
National Provider Identifier
1265364269
Registry record updated Jun 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
95021970 Issued in CA
Practice address
500 N Garfield Ave
Monterey Park, CA 91754-1242
Phone
(626) 572-0661
NPI assigned
Jun 2, 2026
Last updated
Jun 2, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 95021970 CA Primary

Addresses

Primary practice location

500 N Garfield Ave
Monterey Park, CA 91754-1242

Mailing address

935 Summitridge Dr
Diamond Bar, CA 91765-4384
Phone (949) 439-8170

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
95021970CAMDObstetrics & Gynecology Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1780358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780358400000",
    "number": "1265364269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "935 SUMMITRIDGE DR",
            "city": "DIAMOND BAR",
            "state": "CA",
            "postal_code": "917654384",
            "telephone_number": "949-439-8170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 N GARFIELD AVE",
            "city": "MONTEREY PARK",
            "state": "CA",
            "postal_code": "917541242",
            "telephone_number": "626-572-0661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANABE",
        "first_name": "KACEY",
        "middle_name": "BRYCE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-06-02",
        "last_updated": "2026-06-02",
        "certification_date": "2026-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "95021970",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monterey Park, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.