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General NPI Number Information
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NPI Number | 1508907023
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Entity Type | Organization
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Legal Business Name | KARTIK THAKER M.D. INC.
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Dates
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Enumeration Date | 02/09/2007
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Last Update Date | 12/29/2009
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Provider Practice Location Address
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Address Line | 3650 SOUTH ST SUITE 210
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City | LAKEWOOD
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State | CA
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Zip | 90712-1502
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Country | US
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Telephone | 562-630-2360
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Fax | 562-633-0510
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Provider Business Mailing Address
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Address Line | PO BOX 3006
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City | CERRITOS
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State | CA
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Zip | 90703-3006
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Country | US
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Telephone | 562-630-2360
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Fax | 562-633-0510
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Authorized Official
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Title or Position | PRESIDENT
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Name | KARTIK THAKER
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Credential | M.D.
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Telephone | 562-630-2360
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | A45557
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License Number State | CA
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