Individual
MR. DANIEL BRUCE TAKEDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2750 SYCAMORE DRIVE, SUITE 202, SIMI VALLEY, CA 93065-1500
(805) 527-9140
(805) 527-0783
Mailing address
2750 SYCAMORE DRIVE, SUITE 202, SIMI VALLEY, CA 93065-1500
(805) 527-9140
(805) 527-0783
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
G54086
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0065680
—
CA
Enumeration date
09/02/2006
Last updated
10/05/2011
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