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Provider Information for 1699040782

Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know


Other Name:   AMI THAKOR
Gender: FEMALE

Individual NPI: 1699040782

Calendar   Last Updated:  2019-08-20
  Certification Date: 


Name Value
NPI 1699040782
Enumeration Date 2012-03-21
NPI Type 1 - Individual
Sole Proprietor YES
Status Active
Mailing Address 5767 W CENTURY BLVD STE 400
LOS ANGELES, CA 90045-5631
United States

Phone: | Fax:
View Map External Link
Primary Practice Address 19950 RINALDI ST STE 300
PORTER RANCH, CA 91326-4141
United States

Phone: 818-271-2400 | Fax: 818-271-2401
View Map External Link
Secondary Practice Address 1245 16TH ST STE 303
SANTA MONICA, CA 90404-1265
United States

Phone: 310-481-4646 | Fax: 310-899-7599
View Map External Link

Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
Primary Taxonomy Selected Taxonomy State License Number
Yes 207K00000X - Allergy & Immunology CA A128759
No 207R00000X - Internal Medicine CA A128759