Provider Demographics
NPI:1720109663
Name:THOMAS S. TOOMA, M.D. A PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:THOMAS S. TOOMA, M.D. A PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTHALMOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:S
Authorized Official - Last Name:TOOMA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:909-605-1975
Mailing Address - Street 1:3155 SEDONA CT STE D
Mailing Address - Street 2:
Mailing Address - City:ONTARIO
Mailing Address - State:CA
Mailing Address - Zip Code:91764-6559
Mailing Address - Country:US
Mailing Address - Phone:909-605-1975
Mailing Address - Fax:909-974-0356
Practice Address - Street 1:3155 SEDONA CT STE D
Practice Address - Street 2:
Practice Address - City:ONTARIO
Practice Address - State:CA
Practice Address - Zip Code:91764-6559
Practice Address - Country:US
Practice Address - Phone:909-605-1975
Practice Address - Fax:909-974-0356
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG42262207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA48887Medicare UPIN