1922129865 NPI number — THOMAS S TOOMA M D A PROFESSIONAL CORPORATION

Table of content: (NPI 1922129865)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1922129865 NPI number — THOMAS S TOOMA M D A PROFESSIONAL CORPORATION

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
THOMAS S TOOMA M D A PROFESSIONAL CORPORATION
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
NVISION EYE CENTERS
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1922129865
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/09/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 102376
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PASADENA
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
91189-2376
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
949-688-6205
Provider Business Mailing Address Fax Number:
949-688-6205

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4220 VON KARMAN AVE STE 100
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEWPORT BEACH
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92660-2056
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
492-847-4289
Provider Business Practice Location Address Fax Number:
949-854-7331
Provider Enumeration Date:
04/02/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
TOOMA
Authorized Official First Name:
THOMAS
Authorized Official Middle Name:
S.
Authorized Official Title or Position:
OPTHALMOLOGIST
Authorized Official Telephone Number:
949-854-7400

Provider Taxonomy Codes

  • Taxonomy code: 152W00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207W00000X , with the licence number: G42262 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207W00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)