Provider Demographics
NPI:1164564472
Name:TOZIER, MICHAEL DAVID (OD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:DAVID
Last Name:TOZIER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25252 MCINTYRE ST STE D
Mailing Address - Street 2:
Mailing Address - City:LAGUNA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:92653-5448
Mailing Address - Country:US
Mailing Address - Phone:949-586-8200
Mailing Address - Fax:949-586-1538
Practice Address - Street 1:25252 MCINTYRE ST STE D
Practice Address - Street 2:
Practice Address - City:LAGUNA HILLS
Practice Address - State:CA
Practice Address - Zip Code:92653-5448
Practice Address - Country:US
Practice Address - Phone:949-586-8200
Practice Address - Fax:949-586-1538
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA6370152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CASD0052671Medicaid
CAWOP 6370AMedicare ID - Type Unspecified
CASD0052671Medicaid