Individual
DR. DAVID SAMUEL TICHANSKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
200 MEDICAL PLAZA SUITE 214, LOS ANGELES, CA 90095-5563
(310) 794-7788
Mailing address
5767 W CENTURY BLVD STE 400, LOS ANGELES, CA 90045-5631
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
25MA07587100
NJ
208600000X
Surgery Physician
38725
TN
208600000X
Surgery Physician
Primary
C190984
CA
208600000X
Surgery Physician
MD066823L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0177369
—
NJ
05
—
1022206230001
—
PA
05
—
3895577
—
SD
Enumeration date
04/21/2006
Last updated
10/23/2023
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