Provider Demographics
NPI:1952325292
Name:MAGANA, TOMAS ANTONIO (MD)
Entity Type:Individual
Prefix:DR
First Name:TOMAS
Middle Name:ANTONIO
Last Name:MAGANA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:TOMAS
Other - Middle Name:ANTONY
Other - Last Name:MAGANA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 22210
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94623-2210
Mailing Address - Country:US
Mailing Address - Phone:510-535-4000
Mailing Address - Fax:
Practice Address - Street 1:16335 E. 14TH ST.
Practice Address - Street 2:
Practice Address - City:SAN LEANDRO
Practice Address - State:CA
Practice Address - Zip Code:94578
Practice Address - Country:US
Practice Address - Phone:510-481-4567
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2013-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA65684208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics