Individual
NICOLE KIMIKO TAKEDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
155 N FRESNO ST, FRESNO, CA 93701-2302
(559) 459-5196
Mailing address
155 N FRESNO ST, FRESNO, CA 93701-2302
(559) 459-5196
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
A157327
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/10/2015
Last updated
08/13/2018
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