Thaker, Sudevi P

Thaker, Sudevi P is an sole proprietor health care provider with primary practice located at 415 E Harding Way Suite I, Stockton CA 95204-6118. She recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Obstetrics & Gynecology. Allopathic & Osteopathic Physicians / Obstetrics & Gynecology is her primary health care specialty. Thaker, Sudevi P can be contacted via phone (209) 467-1001.

Contact Information

Primary practice address
415 E Harding Way Suite I Stockton CA 95204-6118
Phone: (209) 467-1001
Fax: (209) 467-1005
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X C52147 California
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X C52147 California

Profile Details

NPI number 1932191673
LBN Legal business name Thaker, Sudevi P
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 18th, 2005
Last updated Feb 25th, 2011 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1932191673 NPPES
California MEDICAID 00C521470

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