Provider Demographics
NPI:1437481942
Name:JEFFREY R. TOMAN, M.D., P.C.
Entity Type:Organization
Organization Name:JEFFREY R. TOMAN, M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:R
Authorized Official - Last Name:TOMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:619-686-4011
Mailing Address - Street 1:4060 FOURTH AVE
Mailing Address - Street 2:SUITE 510
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92103-2116
Mailing Address - Country:US
Mailing Address - Phone:619-686-4011
Mailing Address - Fax:619-686-4041
Practice Address - Street 1:4060 FOURTH AVE
Practice Address - Street 2:SUITE 510
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-2116
Practice Address - Country:US
Practice Address - Phone:619-686-4011
Practice Address - Fax:619-686-4041
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-08
Last Update Date:2010-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA83995208C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal SurgeryGroup - Single Specialty