Individual
DR. KEN TAKESITA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4500 BROCKTON AVE STE 301, RIVERSIDE, CA 92501-4027
(951) 276-4505
Mailing address
4500 BROCKTON AVE STE 301, RIVERSIDE, CA 92501-4027
(626) 396-1105
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
A84860
CA
Other
Enumeration date
04/29/2008
Last updated
09/10/2020
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