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Individual

BABAK TASHAKKOR

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
301 W HUNTINGTON DR, SUITE 500, ARCADIA, CA 91007-3462
(626) 793-1227
(626) 793-3794
Mailing address
55 E CALIFORNIA BLVD, 3RD FLOOR, PASADENA, CA 91105-3954
(626) 793-1227
(626) 793-3794

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
A63829
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
A063829
BLUE SHIELD
CA
01
P00068796
MEDICARE RAIL ROAD
CA
Enumeration date
04/28/2006
Last updated
04/02/2009
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