Provider Demographics
NPI:1508427527
Name:LLOYD H TAKAO MD
Entity Type:Organization
Organization Name:LLOYD H TAKAO MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LLOYD
Authorized Official - Middle Name:H
Authorized Official - Last Name:TAKAO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:925-253-1199
Mailing Address - Street 1:15 ALTARINDA RD STE 100
Mailing Address - Street 2:
Mailing Address - City:ORINDA
Mailing Address - State:CA
Mailing Address - Zip Code:94563-2607
Mailing Address - Country:US
Mailing Address - Phone:925-253-1199
Mailing Address - Fax:
Practice Address - Street 1:15 ALTARINDA RD STE 100
Practice Address - Street 2:
Practice Address - City:ORINDA
Practice Address - State:CA
Practice Address - Zip Code:94563-2607
Practice Address - Country:US
Practice Address - Phone:925-253-1199
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-21
Last Update Date:2019-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty