Provider Demographics
NPI:1831254846
Name:MAYER, TOBY GERALD (MD)
Entity type:Individual
Prefix:
First Name:TOBY
Middle Name:GERALD
Last Name:MAYER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:436 N BEDFORD DR
Mailing Address - Street 2:SUITE 202
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90210
Mailing Address - Country:US
Mailing Address - Phone:424-245-4156
Mailing Address - Fax:323-338-7939
Practice Address - Street 1:416 N BEDFORD DR # 200
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90210
Practice Address - Country:US
Practice Address - Phone:310-278-8823
Practice Address - Fax:310-278-2671
Is Sole Proprietor?:No
Enumeration Date:2006-12-27
Last Update Date:2022-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC30193207YX0905X, 2082S0099X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2082S0099XAllopathic & Osteopathic PhysiciansPlastic SurgeryPlastic Surgery Within the Head and Neck
No207YX0905XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngology/Facial Plastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
A34153OtherUPIN