Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0000X | Internist - Cardiovascular Disease | C29468 | CA |
Y | 2080P0202X | Pediatric Cardiologist | C-29468 | CA |
NPI | 1194763243 |
---|---|
Provider Name | Dr. Masato Takahashi |
First Address | Seattle, WA 98144-5043 |
Second Address | Seattle, WA 98105-3901 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/06/2006 |
Last Update Date | 07/08/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1902846306 | GROUP NPI (01) | CA |
C29468 | LICENCE (01) | CA |
GR0100430 | GROUP MEDICAL (01) | CA |
W18762 | GROUP MEDICARE (01) | CA |