Healthcare Provider Details
I. General information
NPI: 1154482933
Provider Name (Legal Business Name): GREGORY K TOUMAYAN DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 12/13/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
290 N 10TH ST SUITE 100
COLTON CA
92324-3052
US
IV. Provider business mailing address
16702 VALLEY VIEW AVE
LA MIRADA CA
90638-5824
US
V. Phone/Fax
- Phone: 909-264-2500
- Fax: 909-264-2510
- Phone: 714-367-5360
- Fax: 714-635-5428
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | DC20056 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: