Provider Demographics
NPI:1003850215
Name:TOKHNER, VADIM (MD)
Entity Type:Individual
Prefix:
First Name:VADIM
Middle Name:
Last Name:TOKHNER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 WEST CARSON STREET
Mailing Address - Street 2:DEPT. OF ANESTHESIOLOGY, BOX #10
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90502-2004
Mailing Address - Country:US
Mailing Address - Phone:424-306-8012
Mailing Address - Fax:310-534-1976
Practice Address - Street 1:1000 W. CARSON STREET
Practice Address - Street 2:DEPT. OF ANESTHESIOLOGY, BOX #10
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90502-2004
Practice Address - Country:US
Practice Address - Phone:424-306-8012
Practice Address - Fax:310-534-1976
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-16
Last Update Date:2021-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA155652207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A556520Medicaid
CAA55652Medicare PIN
CAA55652BMedicare PIN