Individual
DR. MARK C. TAKATA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
10666 N TORREY PINES RD, LA JOLLA, CA 92037-1027
(858) 455-9100
Mailing address
FILE 54433, LOS ANGELES, CA 90074-0001
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
A94975
CA
Other
Enumeration date
04/26/2006
Last updated
09/05/2007
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