Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 122300000X | Dentist | DN19550 | MA |
N | 1223D0004X | Dentist Anesthesiologist | D1201 | CA |
N | 1223D0004X | Dentist Anesthesiologist | DEN1001749 | DC |
Y | 1223D0004X | Dentist Anesthesiologist | DN2228193-A | MA |
N | 1223G0001X | General Practice | 48042 | CA |
N | 213EG0000X | General Practice | 48042 | CA |
NPI | 1376551812 |
---|---|
Provider Name | David Toma |
First Address | Spring Valley, CA 91977 |
Second Address | Spring Valley, CA 91977 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/08/2006 |
Last Update Date | 07/11/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
018242192 | (05) | DC |