Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | A43923 | CA |
NPI | 1003978271 |
---|---|
Provider Name | Dr. Rita Roop Thakur |
First Address | Fremont, CA 94539-5976 |
Second Address | Milpitas, CA 95035-8521 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/12/2006 |
Last Update Date | 08/07/2007 |