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Organization
ROGER Y TAKLA M.D. INC.
Active
Organization
ROGER Y TAKLA M.D. INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROGER Y. TAKLA M.D. (PRESIDENT)
(562) 491-9001
Entity
Organization
Contact information
Practice address
1040 ELM AVE, SUITE 301, LONG BEACH, CA 90813-3267
(562) 491-9001
(562) 491-9283
Mailing address
1040 ELM AVE, SUITE 301, LONG BEACH, CA 90813-3267
(562) 491-9001
(562) 491-9283
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
A29866
CA
208000000X
Pediatrics Physician
A43079
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
GR0024690
CHDP PROVIDER
CA
Enumeration date
11/21/2006
Last updated
10/29/2012
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