Provider Demographics
NPI:1164416087
Name:STEIN, TOMIKO GEORGIA (MD, MPH)
Entity Type:Individual
Prefix:
First Name:TOMIKO
Middle Name:GEORGIA
Last Name:STEIN
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1505 N EDGEMONT ST
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90027-5209
Mailing Address - Country:US
Mailing Address - Phone:323-783-4798
Mailing Address - Fax:323-783-4514
Practice Address - Street 1:1505 N EDGEMONT ST
Practice Address - Street 2:2ND FLOOR
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90027-5209
Practice Address - Country:US
Practice Address - Phone:323-783-4798
Practice Address - Fax:323-783-4514
Is Sole Proprietor?:No
Enumeration Date:2005-09-07
Last Update Date:2021-12-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA54361207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A543610Medicaid
CA00A543610Medicaid