MEDICARE: DR. SUKHDEEP S. TAKHER O.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
1	152W00000X	Optometrist	4037TX	WA
2	152W00000X	Optometrist	12688T	CA

General Provider Information

NPI Number	:	1760412845
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SUKHDEEP S. TAKHER O.D.

Provider Business Mailing Address
First Line	:	1145 COLUSA AVE STE C
Second Line	:
City	:	YUBA CITY
State	:	CA
Zip	:	95991-3630
Country	:	US
Telephone Number	:	530-751-1325
Fax Number	:	530-751-0639

Provider Business Practice Location Address
First Line	:	1145 COLUSA AVE STE C
Second Line	:	NU VISION OPTOMETRY
City	:	YUBA CITY
State	:	CA
Zip	:	95991-3630
Country	:	US
Telephone Number	:	530-751-1325
Fax Number	:	530-751-0639

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/04/2006
Last Update Date	:	03/27/2009

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