Provider Demographics
NPI:1568471092
Name:TOOSIE, KATAYOUN (MD)
Entity Type:Individual
Prefix:
First Name:KATAYOUN
Middle Name:
Last Name:TOOSIE
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 1:3998 VISTA WAY
Mailing Address - Street 2:SUITE C200
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92056-4500
Mailing Address - Country:US
Mailing Address - Phone:760-724-5352
Mailing Address - Fax:760-724-5447
Practice Address - Street 1:3998 VISTA WAY
Practice Address - Street 2:SUITE C200
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92056-4500
Practice Address - Country:US
Practice Address - Phone:760-724-5352
Practice Address - Fax:760-724-5447
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2013-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA60211174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
H73975Medicare UPIN