Takayama 90 Med PLLC

Primary specialty

Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X

License

41788 Issued in AZ

Legal business name

TAKAYAMA 90 MED PLLC

Practice address

14848 N 15TH Dr
Phoenix, AZ 85023-5181

Phone

(214) 615-5168

Fax

(888) 526-9542

NPI assigned

Jan 27, 2014

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Melanie Gross

Title

VP of Revenue Cycle

Phone

(214) 615-5168

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1390780800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1390780800000",
    "number": "1477976546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3837",
            "city": "CAROL STREAM",
            "state": "IL",
            "postal_code": "601323837",
            "telephone_number": "214-615-5168",
            "fax_number": "888-526-9542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14848 N 15TH DR",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850235181",
            "telephone_number": "214-615-5168",
            "fax_number": "888-526-9542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TAKAYAMA 90 MED PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-27",
        "last_updated": "2014-01-27",
        "status": "A",
        "authorized_official_last_name": "GROSS",
        "authorized_official_first_name": "MELANIE",
        "authorized_official_title_or_position": "VP OF REVENUE CYCLE",
        "authorized_official_telephone_number": "214-615-5168"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "AZ",
            "license": "41788",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maria Cecilia Tajan, OTR/L
• Aubrey Takacs
• Jacqueline Vera Takacs, PHARM D
• Robert Frank Takacs, MD
• Bruce A. Takahashi, DO
• Naoki Takayama, M.D.
• Take Back Your Life Weight Loss Solutions, LLC
• Take Heart Counseling & Consulting, PLLC
• Hideyuki Takeuchi
• Daniel Essam Takla, MD

• Pain Medicine (Anesthesiology) Physician in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Pain Medicine (Anesthesiology) Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.