Individual
JOHN ICHIRO TAKAYAMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M. D.
Contact information
Practice address
UCSF MEDICAL CENTER CHILDRENS HOSPITAL, 400 PARNASSUS AVE 2ND FLOOR, SAN FRANCISCO, CA 94143
(415) 353-2211
Mailing address
UCSF MEDICAL CENTER CHILDRENS HOSPITAL, 400 PARNASSUS AVE 2ND FLOOR, SAN FRANCISCO, CA 94143
(415) 353-2211
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
G67205
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G672050
MEDI-CAL PIN
CA
Enumeration date
06/15/2007
Last updated
07/08/2007
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