Healthcare Provider Details

I. General information

NPI: 1447432653
Provider Name (Legal Business Name): KENNETH M. TOKITA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/29/2007
Last Update Date: 08/01/2022
Certification Date: 08/01/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16100 SAND CANYON AVE STE 130
IRVINE CA
92618-3722
US

IV. Provider business mailing address

16100 SAND CANYON AVE STE 130
IRVINE CA
92618-3722
US

V. Phone/Fax

Practice location:
  • Phone: 949-417-1100
  • Fax: 949-417-1165
Mailing address:
  • Phone: 949-417-1100
  • Fax: 949-417-1165

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License NumberG18258
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: