Provider Demographics
NPI:1609809854
Name:TOVAR, LILIA (MD)
Entity Type:Individual
Prefix:
First Name:LILIA
Middle Name:
Last Name:TOVAR
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 1:2050 S BLOSSER RD
Mailing Address - Street 2:
Mailing Address - City:SANTA MARIA
Mailing Address - State:CA
Mailing Address - Zip Code:93458-7310
Mailing Address - Country:US
Mailing Address - Phone:805-361-8028
Mailing Address - Fax:805-361-8097
Practice Address - Street 1:430 S BLOSSER RD
Practice Address - Street 2:
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93458-4908
Practice Address - Country:US
Practice Address - Phone:805-361-8900
Practice Address - Fax:805-361-8990
Is Sole Proprietor?:No
Enumeration Date:2006-07-09
Last Update Date:2018-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA87101207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAFHC70477FMedicaid
CAZZZ69714ZOtherBLUE SHIELD OF CALIFORNIA
CACQ493WMedicare PIN
CAW1508BMedicare PIN
CAW1508EMedicare PIN
CAZZZ69714ZOtherBLUE SHIELD OF CALIFORNIA
CAWA87101Medicare PIN
CACQ493XMedicare PIN
CAI13064Medicare UPIN
CAW1508Medicare PIN
CA051108Medicare Oscar/Certification
CAW1508AMedicare PIN
CACQ493YMedicare PIN