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NPI Code Detail

MEDICARE: JULIE M THAKKAR

MEDICARE: JULIE M THAKKAR
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
1390200000XStudent in an Organized Health Care Education/Training ProgramINT53378CA

General Provider Information

NPI Number : 1962377937
Entity Type Code : Individual
Provider Name (Legal Business Name) : JULIE M THAKKAR
Provider Business Mailing Address
First Line : 1985 ZONAL AVE
Second Line :
City : LOS ANGELES
State : CA
Zip : 90089-5305
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1985 ZONAL AVE
Second Line :
City : LOS ANGELES
State : CA
Zip : 90089-5305
Country : US
Telephone Number : 949-750-6750
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/08/2025
Last Update Date : 04/15/2026

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