Individual
TIMOTHY L VANNATTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1000 W CARSON ST, BOX 42, TORRANCE, CA 90502-2004
(310) 222-5026
Mailing address
21840 NORMANDIE AVE, SUITE 100, TORRANCE, CA 90502-2047
(310) 222-5026
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
G88765
CA
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
G87765
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0207605
—
IA
01
—
17556
WELLMARK BCBS
IA
Enumeration date
08/30/2005
Last updated
02/01/2008
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