Mark H Takemura, MD

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

G58448 Issued in CA

Practice address

20911 Earl Street
Suite 280
Torrance, CA 90503

Phone

(310) 214-7236

Fax

(310) 542-0334

NPI assigned

Nov 29, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Providence Medical Institute

  • Family Medicine Physician
  • Torrance, CA
  • NPI 1417915760
  Medicare reassignment NPD
• Gastroenterology Associates of the South Bay a Profess Medical Corp

  • Gastroenterology Physician
  • Torrance, CA
  • NPI 1518975879
  NPD (past) Authorized official
• Providence Medical Institute

  • Family Medicine Physician
  • Torrance, CA
  • NPI 1235182569
  NPD

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

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618876800000",
    "number": "1487721189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20911 EARL STREET",
            "address_2": "SUITE 280",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "90503",
            "telephone_number": "310-214-7236",
            "fax_number": "310-542-0334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20911 EARL STREET",
            "address_2": "SUITE 280",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "90503",
            "telephone_number": "310-214-7236",
            "fax_number": "310-542-0334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAKEMURA",
        "first_name": "MARK",
        "middle_name": "H",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-29",
        "last_updated": "2021-04-20",
        "certification_date": "2021-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CA",
            "license": "G58448",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0047331",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mtakemura405810@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "20911 Earl St Ste 220",
            "city": "Torrance",
            "state": "CA",
            "country_code": "US",
            "postal_code": "905034353",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Aileen Miyoko Takahashi, MD
• Chinatsu Takahashi
• Lori Takaki
• Jon Takeo Takara, DDS
• Keely Takayama, PT, DPT
• Risa Takeuchi
• Adam Talaat
• Samantha A Talavera
• Armin Talle
• Samantha M Talosig, RN

• Gastroenterology Physician in Torrance, CA
• Providers in Torrance, CA by specialty
• Gastroenterology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.