Provider Demographics
NPI:1861503401
Name:OYKHMAN, VLADIMIR (MD)
Entity Type:Individual
Prefix:
First Name:VLADIMIR
Middle Name:
Last Name:OYKHMAN
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 1:625 LINCOLN AVE
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95126-3785
Mailing Address - Country:US
Mailing Address - Phone:408-871-3400
Mailing Address - Fax:
Practice Address - Street 1:625 LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95126-3785
Practice Address - Country:US
Practice Address - Phone:408-871-3400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2020-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA39980208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A399800Medicaid
CAA29011Medicare UPIN
CA00A399800Medicare ID - Type Unspecified