Healthcare Provider Details

I. General information

NPI: 1831254846
Provider Name (Legal Business Name): TOBY GERALD MAYER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/27/2006
Last Update Date: 05/11/2022
Certification Date: 05/11/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

416 N BEDFORD DR # 200
BEVERLY HILLS CA
90210
US

IV. Provider business mailing address

436 N BEDFORD DR SUITE 202
BEVERLY HILLS CA
90210
US

V. Phone/Fax

Practice location:
  • Phone: 310-278-8823
  • Fax: 310-278-2671
Mailing address:
  • Phone: 424-245-4156
  • Fax: 323-338-7939

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207YX0905X
TaxonomyOtolaryngology/Facial Plastic Surgery Physician
License NumberC30193
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code2082S0099X
TaxonomyPlastic Surgery Within the Head and Neck (Plastic Surgery) Physician
License NumberC30193
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: