Individual
DR. KUNTAL M THAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2850 COMMERCIAL CROSSING, SANTA CRUZ, CA 95065-1702
(831) 460-7350
(831) 460-7351
Mailing address
2025 SOQUEL AVE., SANTA CRUZ, CA 95062-1323
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
E-4883
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
161442001
—
AR
Enumeration date
05/03/2006
Last updated
09/18/2012
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