Organization
GLENN K. TAKEI, M.D., INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMBER JORDAN (OFFICE FACILITATOR)
(626) 357-9931
Entity
Organization
Contact information
Practice address
931 BUENA VISTA ST, SUITE 505, DUARTE, CA 91010-1712
(626) 357-9931
(626) 359-0739
Mailing address
931 BUENA VISTA ST, SUITE 505, DUARTE, CA 91010-1712
(626) 357-9931
(626) 359-0739
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
G35093
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G350930
—
CA
Enumeration date
04/12/2010
Last updated
04/12/2010
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