Individual
DR. VICTOR N TAKLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1015 NW 22ND AVE, PORTLAND, OR 97210-3025
(208) 667-6511
(208) 666-1642
Mailing address
4136 NW THUNDER CREST RD, PORTLAND, OR 97229-8028
(208) 667-6511
(208) 666-1642
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
MD15896
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
043802
—
OR
01
—
050043869
RR MEDICARE
OR
05
—
1160456
—
WA
05
—
XPY194606
—
CA
Enumeration date
08/03/2006
Last updated
04/13/2009
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