Provider Demographics
NPI:1669407268
Name:TOHM, DONALD GORDON (MD)
Entity type:Individual
Prefix:
First Name:DONALD
Middle Name:GORDON
Last Name:TOHM
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 1:1701 26TH ST
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93301-2803
Mailing Address - Country:US
Mailing Address - Phone:661-324-9606
Mailing Address - Fax:661-322-0506
Practice Address - Street 1:1701 26TH ST
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93301-2803
Practice Address - Country:US
Practice Address - Phone:661-324-9606
Practice Address - Fax:661-322-0506
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG55650207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0G556500Medicaid
CA0G556500Medicaid