Healthcare Provider Details

I. General information

NPI: 1124058565
Provider Name (Legal Business Name): TOSI MARCELINE LM, CPM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/03/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26990 COUNTY ROAD 95A
DAVIS CA
95616-9443
US

IV. Provider business mailing address

26990 ROAD 95A
DAVIS CA
95616-9443
US

V. Phone/Fax

Practice location:
  • Phone: 530-756-8202
  • Fax: 539-753-6142
Mailing address:
  • Phone: 530-756-8202
  • Fax: 539-753-6142

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License NumberLM0010
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: