Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Jack Ryan Takahashi, MD

Individual provider Physical Medicine & Rehabilitation Physician · NPI 1013593466

Jack Ryan Takahashi, MD is a Physical Medicine and Rehabilitation in Vallejo, California. Graduated from University of California, Geffen School of Medicine in 2021, 5 years ago. Practices with Permanente Medical Group Inc, a 10,941-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
5
Trained at
University of California, Geffen School of Medicine
Licensed in
CA
In the registry since
2021
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

975 Sereno Dr # 218
Vallejo, CA 94589-2441
Phone: (707) 651-1000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Medicine & Rehabilitation Physician (primary) Taxonomy 208100000X · Licence A182209 (CA)

Record details

NPI number1013593466
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedMarch 23, 2021
Last updated in NPPESSeptember 26, 2025
Certification dateSeptember 26, 2025
Mailing address975 Sereno Dr # 218, Vallejo, CA 94589-2441

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL MEDICINE AND REHABILITATION
Medical schoolUNIVERSITY OF CALIFORNIA, GEFFEN SCHOOL OF MEDICINE
Graduated 2021 (5 years in practice)
Group practice Permanente Medical Group Inc — 10941 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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