Provider Demographics
NPI:1043392103
Name:TOSTADO, MARINA L (MD)
Entity Type:Individual
Prefix:
First Name:MARINA
Middle Name:L
Last Name:TOSTADO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 E EL CAMNIO REAL
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN VIEW
Mailing Address - State:CA
Mailing Address - Zip Code:94040-0000
Mailing Address - Country:US
Mailing Address - Phone:650-934-7808
Mailing Address - Fax:
Practice Address - Street 1:701 E EL CAMNIO REAL
Practice Address - Street 2:
Practice Address - City:MOUNTAIN VIEW
Practice Address - State:CA
Practice Address - Zip Code:94040-0000
Practice Address - Country:US
Practice Address - Phone:650-934-7808
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-19
Last Update Date:2012-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA75458207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A754580Medicaid
CA00A754580Medicare ID - Type UnspecifiedMEDICARE NUMBER
CA00A754580Medicaid