Provider Demographics
NPI:1184818684
Name:TOLAN, AMY M (MD)
Entity Type:Individual
Prefix:DR
First Name:AMY
Middle Name:M
Last Name:TOLAN
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Gender:F
Credentials:MD
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Mailing Address - Street 1:3600 BROADWAY STE 300
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94611-5730
Mailing Address - Country:US
Mailing Address - Phone:510-752-1105
Mailing Address - Fax:310-533-1841
Practice Address - Street 1:275 W MACARTHUR
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94611-5641
Practice Address - Country:US
Practice Address - Phone:510-752-1000
Practice Address - Fax:310-533-1841
Is Sole Proprietor?:No
Enumeration Date:2007-08-28
Last Update Date:2022-01-26
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Provider Licenses
StateLicense IDTaxonomies
CAA103257208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery