Healthcare Provider Details

I. General information

NPI: 1881011278
Provider Name (Legal Business Name): REBECCA ANNE DIXON TOKUHARA CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2014
Last Update Date: 03/13/2023
Certification Date: 03/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35900 BOB HOPE DR STE 175
RANCHO MIRAGE CA
92270-1767
US

IV. Provider business mailing address

39000 BOB HOPE DR STE W105
RANCHO MIRAGE CA
92270-7033
US

V. Phone/Fax

Practice location:
  • Phone: 760-340-4700
  • Fax: 760-568-2490
Mailing address:
  • Phone: 832-287-3387
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number95000344
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: