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Individual

PINKY R THAKKAR

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
P.A.-C

Contact information

Practice address
2121 SANTA MONICA BLVD., SANTA MONICA, CA 90404
(310) 829-8212
Mailing address
2121 SANTA MONICA BLVD., SANTA MONICA, CA 90404
(310) 829-8212

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA18085
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
WPA18085A
PPIN NUMBER
CA
Enumeration date
10/03/2006
Last updated
06/03/2010
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