# SHANTANU THAKUR, P.C.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1811559347
- **Authorized official:** SHANTANU KUMAR THAKUR MD (CEO)
- **Authorized official phone:** (213) 283-9202

## Contact information

- **Practice address:** 13039 VICTORY BLVD, NORTH HOLLYWOOD, CA 91606-2925
- **Practice address phone:** (213) 283-9202
- **Practice address fax:** (213) 260-2306
- **Mailing address:** 440 N BARRANCA AVE STE 9202, COVINA, CA 91723-1722
- **Mailing address phone:** (213) 283-9202
- **Mailing address fax:** (213) 260-2306

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | NULL | Yes |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | — | Yes |

## Other

- **Enumeration date:** 07/04/2019
- **Last updated:** 07/29/2024