Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 20A14541 | CA |
N | 207VG0400X | Gynecologist | 20A14541 | CA |
N | 207VX0000X | Obstetrician | 20A14541 | CA |
NPI | 1023384526 |
---|---|
Provider Name | Freshta Kakar |
First Address | Rancho Cordova, CA 95670-7956 |
Second Address | El Dorado Hills, CA 95762-9364 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/03/2012 |
Last Update Date | 17/03/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
20A14541 | MEDICAL STATE LICENSE (01) | CA |