Provider Demographics
NPI:1558665562
Name:THAKKAR, PUJA ANIL (DO)
Entity Type:Individual
Prefix:DR
First Name:PUJA
Middle Name:ANIL
Last Name:THAKKAR
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:400 EL CERRO BLVD #107
Mailing Address - Street 2:GOLDEN GATE SLEEP CENTERS
Mailing Address - City:DANVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:94526-1731
Mailing Address - Country:US
Mailing Address - Phone:925-820-4472
Mailing Address - Fax:
Practice Address - Street 1:400 EL CERRO BLVD #107
Practice Address - Street 2:GOLDEN GATE SLEEP CENTERS
Practice Address - City:DANVILLE
Practice Address - State:CA
Practice Address - Zip Code:94526-1731
Practice Address - Country:US
Practice Address - Phone:925-820-4472
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-05
Last Update Date:2024-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A12339207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine