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Individual

DR. PANKAJ D THAKER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
415 E HARDING WAY, SUITE I, STOCKTON, CA 95204-6118
(209) 467-1001
(209) 467-1005
Mailing address
415 E HARDING WAY, SUITE I, STOCKTON, CA 95204-6118
(209) 467-1001
(209) 467-1005

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
C52146
CA
207V00000X
Obstetrics & Gynecology Physician
Primary
C52146
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00C521460
CA
Enumeration date
08/18/2005
Last updated
02/25/2011
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