Individual
ANDREW J TAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1111 EXPOSITION BLVD, BLDG 400A, SACRAMENTO, CA 95815-4314
(916) 646-4583
(916) 646-4056
Mailing address
PO BOX 4578, DAVIS, CA 95617
(916) 646-4583
(916) 646-4056
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
G78315
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G783150
—
CA
Enumeration date
10/14/2006
Last updated
06/03/2014
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