DR. SUDEVI P THAKER (NPI# 1932191673) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932191673 |
| Entity Type | Individual |
| Full Name | DR. SUDEVI P THAKER |
| Credential | M.D. |
| Practice Address |
415 E Harding Way Suite I Stockton CA 95204-6118 |
| Practice Telephone | 2094671001 |
| Practice Fax Number | 2094671005 |
| Mailing Telephone | 2094671001 |
| Mailing Fax Number | 2094671005 |
| Enumeration Date | 2005-08-18 |
| Last Update Date | 2011-02-25 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 174400000X | Specialist | C52147 | CA | Other Service Providers |
| Y | 207V00000X | Obstetrics & Gynecology | C52147 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 00C521470 | 05 |
| Street Address |
415 E HARDING WAY SUITE I |
| City | STOCKTON |
| State | CA |
| Zip Code | 95204-6118 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104827906 | Ronald C Allison | Specialist | 415 E Harding Way, #h, Stockton, CA 95204-6118 | 2005-08-03 |
| 1669755682 | Caroline D Andersen | Physician Assistant | 415 E Harding Way, Suite D, Stockton, CA 95204-6118 | 2011-09-26 |
| 1942589965 | Donna J Burke | Nurse Practitioner | 415 E Harding Way, Suite D, Stockton, CA 95204-6118 | 2011-08-08 |
| 1790080281 | Dr Thaker Md, A Professional Corporation | Obstetrics & Gynecology | 415 E Harding Way, Suite I, Stockton, CA 95204-6118 | 2011-01-14 |
| 1528362050 | Sutter Gould Medical Foundation | Clinic/Center | 415 E Harding Way, Suite E, Stockton, CA 95204-6118 | 2010-12-23 |
| 1700035334 | Masanobu Kamigaki | Internal Medicine | 415 E Harding Way, Suite D, Stockton, CA 95204-6118 | 2008-09-18 |
| 1659539153 | Ajay K Toppur Ramanakumar | Internal Medicine | 415 E Harding Way, Suite D, Stockton, CA 95204-6118 | 2008-05-30 |
| 1386657666 | Stockton Endoscopy Center LLC | Clinic/Center | 415 E Harding Way, Suite E, Stockton, CA 95204 | 2006-08-15 |
| 1346276359 | Dean Karnaze | Specialist | 415 E Harding Way, Ste F, Stockton, CA 95204-6118 | 2006-06-23 |
| 1790720688 | Ronald Floyd Dugger | Specialist | 415 E Harding Way, Ste F, Stockton, CA 95204-6118 | 2006-06-17 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962027524 | Kariem Abdelwahed | Licensed Vocational Nurse | 1630 N. Edison St Stockton Ca, Stockton, CA 95204 | 2020-06-10 |
| 1831730555 | Ronnie C Murray | Counselor | 1947 North California Street, Stockton, CA 95204 | 2019-10-03 |
| 1235614116 | Michelle Ann Horn | Marriage & Family Therapist | 3666 Mission Rd, Stockton, CA 95204 | 2018-09-26 |
| 1356830947 | Stockton Pace | PACE Provider Organization | 582 E. Harding Way, Stockton, CA 95204 | 2018-05-09 |
| 1790228781 | Rebecca Phongsa | Counselor | 1947 North Calfornia Street, Suite B, Stockton, CA 95204 | 2016-11-23 |
| 1700332905 | Serim Kang | Driver | 4222 N Pershing Ave, Suite D2, Stockton, CA 95204 | 2016-08-28 |
| 1033565544 | Philip John Brereton | Orthotist | 466 E Harding Way, Stockton, CA 95204 | 2016-05-13 |
| 1932507522 | David Grayson | Counselor | 1621 Brookside Rd, Stockton, CA 95204 | 2014-12-12 |
| 1174934897 | Gurtej Malhi | Internal Medicine | 1901 N California Street, Stockton, CA 95204 | 2014-05-15 |
| 1396156170 | Rajesh Saini | Nurse Practitioner | 1805 N California St. Suite 102, Stockton, CA 95204 | 2014-05-14 |
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| Taxonomy Code | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154689677 | Stacy Marie Yadava | Obstetrics & Gynecology | 1617 N California St Ste 2d, Stockton, CA 95204 | 2012-05-03 |
| 1881869741 | Maria Estela Escalona | Obstetrics & Gynecology | 1617 N California St Ste 2b, Stockton, CA 95204-6117 | 2008-04-23 |
| 1679780712 | Kimberly Patrice Mclaughlin | Obstetrics & Gynecology | 1617 N. California Street, Suite 2a, Stockton, CA 95204 | 2007-05-17 |
| 1891867602 | Thomas S.c. Leong | Obstetrics & Gynecology | 10631 Tank House Dr, Stockton, CA 95209-4340 | 2006-11-15 |
| 1013002716 | Melba Agatep Berbano | Obstetrics & Gynecology | 1801 E March Ln Ste C320, Stockton, CA 95210-6676 | 2006-10-04 |
| 1437158706 | Shermilla Shunmugham | Obstetrics & Gynecology | 1617 N California St, Ste 2b, Stockton, CA 95204-6117 | 2005-07-19 |
| 1538681432 | Jasbir Singh Gill | Obstetrics & Gynecology | 1617 N California St Ste 2d, Stockton, CA 95204-6117 | 2017-07-12 |
| 1003202417 | Karen Swarer | Obstetrics & Gynecology | 1617 N California St Ste 2a, Stockton, CA 95204-6117 | 2015-04-13 |
| 1447652524 | Molly Campbell | Obstetrics & Gynecology | 1617 N California St Ste 2a, Stockton, CA 95204-6117 | 2014-09-21 |
| 1740690718 | Nataliya Vang | Obstetrics & Gynecology | 2545 W Hammer Ln, Stockton, CA 95209-2839 | 2014-04-30 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.