Individual
DANIEL R TAKETA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
611 E OCEAN AVE, LOMPOC, CA 93436-6914
(805) 736-7010
(805) 736-7589
Mailing address
611 E OCEAN AVE, LOMPOC, CA 93436-6914
(805) 736-7010
(805) 736-7589
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
7368TPA
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
SD0073680
—
CA
Enumeration date
08/31/2006
Last updated
02/12/2010
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