Individual
KENNETH PAUL TAKAKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
400 N PEPPER AVE, COLTON, CA 92324-1801
(909) 580-6370
Mailing address
400 N PEPPER AVE, COLTON, CA 92324-1801
(909) 580-6370
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
20A10221
CA
Other
Enumeration date
12/12/2007
Last updated
12/12/2007
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