Basic Information
| Provider Information | |||||||||
| NPI: | 1922539972 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | THAKKAR | ||||||||
| FirstName: | NANCY | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1425 S MAIN ST | ||||||||
| Address2: | HBS DEPARTMENT | ||||||||
| City: | WALNUT CREEK | ||||||||
| State: | CA | ||||||||
| PostalCode: | 945965318 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9252954000 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1364 CLIFTON RD NE | ||||||||
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| City: | ATLANTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 303221059 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4047787077 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/22/2017 | ||||||||
| LastUpdateDate: | 12/27/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 01/16/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 169937 | CA | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.