Provider Demographics
NPI:1760412845
Name:TAKHER, SUKHDEEP S (OD)
Entity Type:Individual
Prefix:DR
First Name:SUKHDEEP
Middle Name:S
Last Name:TAKHER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1145 COLUSA AVE STE C
Mailing Address - Street 2:
Mailing Address - City:YUBA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:95991-3630
Mailing Address - Country:US
Mailing Address - Phone:530-751-1325
Mailing Address - Fax:530-751-0639
Practice Address - Street 1:1145 COLUSA AVE STE C
Practice Address - Street 2:NU VISION OPTOMETRY
Practice Address - City:YUBA CITY
Practice Address - State:CA
Practice Address - Zip Code:95991-3630
Practice Address - Country:US
Practice Address - Phone:530-751-1325
Practice Address - Fax:530-751-0639
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-04
Last Update Date:2009-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA4037TX152W00000X
CA12688T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAV08220Medicare UPIN