Provider Demographics
NPI:1043318512
Name:VANLEY, CHRISTOPHER TOSOONIAN (MD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:TOSOONIAN
Last Name:VANLEY
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 1:460 EL CAMINO DEL MAR
Mailing Address - Street 2:
Mailing Address - City:LAGUNA BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92651
Mailing Address - Country:US
Mailing Address - Phone:949-494-0102
Mailing Address - Fax:949-494-5950
Practice Address - Street 1:31872 COAST HWY
Practice Address - Street 2:SOUTH COAST MEDICAL CENTER, PATHOLOGY DEPT
Practice Address - City:LAGUNA BEACH
Practice Address - State:CA
Practice Address - Zip Code:92651
Practice Address - Country:US
Practice Address - Phone:949-499-7181
Practice Address - Fax:949-499-7248
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2007-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC0038111207ZD0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZD0900XAllopathic & Osteopathic PhysiciansPathologyDermatopathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
00C381110OtherBLUE CROSS
CA00C381110Medicaid
CAC38111OtherSTATE LICENSE NUMBER
00C381110OtherBLUE SHIELD
CAWC38111AMedicare PIN
00C381110OtherBLUE CROSS