Individual
DEVANSHU HARENDRA THAKORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1081 N CHINA LAKE BLVD, RIDGECREST, CA 93555-3130
(760) 446-3551
(760) 446-2254
Mailing address
1081 N CHINA LAKE BLVD, RIDGECREST, CA 93555-3130
(760) 499-3899
(760) 446-2254
Taxonomy
Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
Primary
11043
NV
208M00000X
Hospitalist Physician
Primary
C128303
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100503572
—
NV
01
—
DA857Z
NEW MEDICARE PTAN FROM PALMETTO
NV
Enumeration date
02/15/2006
Last updated
04/13/2026
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