Provider Demographics
NPI:1821188368
Name:MICHAEL TOISERKANI, M.D., INC.
Entity Type:Organization
Organization Name:MICHAEL TOISERKANI, M.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:TOISERKANI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-562-9509
Mailing Address - Street 1:1821 WILSHIRE BLVD #210
Mailing Address - Street 2:
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90403-5618
Mailing Address - Country:US
Mailing Address - Phone:310-453-1324
Mailing Address - Fax:
Practice Address - Street 1:1821 WILSHIRE BLVD #210
Practice Address - Street 2:
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90403-5618
Practice Address - Country:US
Practice Address - Phone:310-453-1324
Practice Address - Fax:310-453-8085
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-13
Last Update Date:2010-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA76707207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A767071Medicaid
CAH49590Medicare UPIN