Provider Demographics
NPI:1598766446
Name:TOVAR, EDUARDO A (MD)
Entity Type:Individual
Prefix:MR
First Name:EDUARDO
Middle Name:A
Last Name:TOVAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
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:562-789-4416
Is Sole Proprietor?:No
Enumeration Date:2005-08-02
Last Update Date:2016-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA38670208600000X, 208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00012268OtherRAILROAD MEDICARE
CACGP168215OtherCCS MEDI-CAL
CA1598766446Medicaid
CA00A386700Medicaid
CAWA38670COtherMEDICARE INDIVIDUAL PTAN
CA00A386700Medicaid
WA38670CMedicare PIN