MEDICARE: MR. JIMMY TOVAR B.A.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2355S0801X	Speech-Language Assistant	SPA2590	CA
2	235Z00000X	Speech-Language Pathologist	36944	CA

General Provider Information

NPI Number	:	1073931473
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JIMMY TOVAR B.A.

Provider Business Mailing Address
First Line	:	2020 BARRANCA ST APT 418
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90031-1778
Country	:	US
Telephone Number	:	213-590-0304
Fax Number	:

Provider Business Practice Location Address
First Line	:	2020 BARRANCA ST APT 418
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90031-1778
Country	:	US
Telephone Number	:	213-590-0304
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/02/2014
Last Update Date	:	01/11/2026

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Directions to “ MR. JIMMY TOVAR B.A.” Practice Location

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