Provider Demographics
NPI:1073605382
Name:MARY TOFT, M.D. A MEDICAL CORPORATION
Entity Type:Organization
Organization Name:MARY TOFT, M.D. A MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:TOFT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:661-940-7600
Mailing Address - Street 1:44725 10TH ST W
Mailing Address - Street 2:SUITE 260
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93534-3033
Mailing Address - Country:US
Mailing Address - Phone:661-940-7600
Mailing Address - Fax:661-726-4318
Practice Address - Street 1:44725 10TH ST W
Practice Address - Street 2:SUITE 260
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93534-3033
Practice Address - Country:US
Practice Address - Phone:661-940-7600
Practice Address - Fax:661-726-4318
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-28
Last Update Date:2012-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG67425174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAE97335Medicare UPIN
CAG67425Medicare ID - Type Unspecified