Individual
ROMAN Y TAKASAKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
336 W 100 S, SPANISH FORK, UT 84660-5881
(801) 798-7301
(801) 798-8513
Mailing address
325 W CENTER ST, SPANISH FORK, UT 84660-2060
(801) 798-7301
(801) 798-8513
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
182230-1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10007
—
UT
Enumeration date
05/25/2006
Last updated
07/11/2023
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