Individual
LAUREN GRACE TAKATA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1520 SAN PABLO ST, SUITE 2000, LOS ANGELES, CA 90033-5310
(323) 442-5303
Mailing address
1520 SAN PABLO ST, SUITE 2000, LOS ANGELES, CA 90033-5310
(323) 442-5303
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
012272
NY
363AS0400X
Surgical Physician Assistant
Primary
PA23185
CA
Other
Enumeration date
05/25/2010
Last updated
11/21/2013
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