Basic Information
| Provider Information | |||||||||
| NPI: | 1851736961 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | TAKYAR | ||||||||
| FirstName: | VARUN | ||||||||
| MiddleName: | KUMAR | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 325 DISTEL CIR | ||||||||
| Address2: | |||||||||
| City: | LOS ALTOS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 940221408 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9257767725 | ||||||||
| FaxNumber: | 5105067728 | ||||||||
| Practice Location | |||||||||
| Address1: | 4053 LONE TREE WAY STE 201 | ||||||||
| Address2: | |||||||||
| City: | ANTIOCH | ||||||||
| State: | CA | ||||||||
| PostalCode: | 945316210 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9257767725 | ||||||||
| FaxNumber: | 5105067728 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/02/2013 | ||||||||
| LastUpdateDate: | 01/29/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 01/29/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RG0100X | CA | CA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Gastroenterology | 207RI0008X | A130685 | CA | N | Allopathic & Osteopathic Physicians | Internal Medicine | Hepatology |
ID Information
| ID | Type | State | Issuer | Description | FT7451797 | 05 | CA | MEDICAID |