Basic Information
| Provider Information | |||||||||
| NPI: | 1770790461 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | TAKAHASHI | ||||||||
| FirstName: | DONNA | ||||||||
| MiddleName: | M | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 178 | ||||||||
| Address2: | |||||||||
| City: | SOQUEL | ||||||||
| State: | CA | ||||||||
| PostalCode: | 95073 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8314599424 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 75 NIELSON ST | ||||||||
| Address2: | WATSONVILLE COMMUNITY HOSPITAL | ||||||||
| City: | WATSONVILLE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 950762468 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8317615661 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/16/2007 | ||||||||
| LastUpdateDate: | 05/05/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | G41048 | CA | Y | Allopathic & Osteopathic Physicians | Pediatrics |
No ID Information.