Provider Demographics
NPI:1003871161
Name:TAKHAR, SUKHJIT SINGH (MD)
Entity Type:Individual
Prefix:DR
First Name:SUKHJIT
Middle Name:SINGH
Last Name:TAKHAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 PORTOLA RD STE A
Mailing Address - Street 2:
Mailing Address - City:PORTOLA VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94028-7852
Mailing Address - Country:US
Mailing Address - Phone:650-530-0015
Mailing Address - Fax:650-353-9266
Practice Address - Street 1:150 PORTOLA RD STE A
Practice Address - Street 2:
Practice Address - City:PORTOLA VALLEY
Practice Address - State:CA
Practice Address - Zip Code:94028-7852
Practice Address - Country:US
Practice Address - Phone:650-530-0015
Practice Address - Fax:650-353-9266
Is Sole Proprietor?:No
Enumeration Date:2006-04-19
Last Update Date:2024-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA75198207P00000X, 207R00000X, 207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A751980Medicaid
CA930117624OtherRAILROAD
CA00A751980Medicare ID - Type UnspecifiedMEDICARE
CA930117624OtherRAILROAD