Healthcare Provider Details

I. General information

NPI: 1871295857
Provider Name (Legal Business Name): TYLER CAMERON TOLOPKA DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/21/2023
Last Update Date: 02/07/2025
Certification Date: 02/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 MERCY CIRCLE RD
CAMP PENDLETON CA
92055
US

IV. Provider business mailing address

200 MERCY CIRCLE RD
CAMP PENDLETON CA
92055
US

V. Phone/Fax

Practice location:
  • Phone: 760-719-5100
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171000000X
TaxonomyMilitary Health Care Provider
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2083A0100X
TaxonomyAerospace Medicine Physician
License Number0102208839
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: