Provider Demographics
NPI:1417074683
Name:EDUARDO A TOVAR, M.D. A MEDICAL CORP
Entity Type:Organization
Organization Name:EDUARDO A TOVAR, M.D. A MEDICAL CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:EDUARDO
Authorized Official - Middle Name:A
Authorized Official - Last Name:TOVAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:562-789-5489
Mailing Address - Street 1:12462 PUTNAM ST.
Mailing Address - Street 2:SUITE 200
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90602-1002
Mailing Address - Country:US
Mailing Address - Phone:562-789-5489
Mailing Address - Fax:562-907-2492
Practice Address - Street 1:12462 PUTNAM ST.
Practice Address - Street 2:SUITE 200
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90602-1002
Practice Address - Country:US
Practice Address - Phone:562-789-5489
Practice Address - Fax:562-907-2492
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-23
Last Update Date:2009-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA38670208600000X, 208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)Group - Multi-Specialty
No208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAP00012268OtherRAILROAD MEDICARE
CA1417074683Medicaid
CAW21668OtherMEDICARE PTAN
CA00A386700Medicaid
CACGP168215Medicaid
CA1417074683Medicaid
CAP00012268OtherRAILROAD MEDICARE
W21668Medicare PIN