Provider Demographics
NPI:1235197856
Name:TOULOUIE, ELAHE (MD)
Entity Type:Individual
Prefix:
First Name:ELAHE
Middle Name:
Last Name:TOULOUIE
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 1:5033 MCGILL WAY
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92130-2711
Mailing Address - Country:US
Mailing Address - Phone:619-838-2072
Mailing Address - Fax:
Practice Address - Street 1:8851 CENTER DR
Practice Address - Street 2:STE 301
Practice Address - City:LA MESA
Practice Address - State:CA
Practice Address - Zip Code:91942-3017
Practice Address - Country:US
Practice Address - Phone:619-461-3515
Practice Address - Fax:619-461-0382
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-03
Last Update Date:2008-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA73141207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A731410Medicaid
H32487Medicare UPIN
CAW1850Medicare ID - Type Unspecified