Healthcare Provider Details

I. General information

NPI: 1962965327
Provider Name (Legal Business Name): TATUM M TONER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/11/2019
Last Update Date: 02/27/2023
Certification Date: 02/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1313 E HERNDON AVE STE 105
FRESNO CA
93720-3306
US

IV. Provider business mailing address

1313 E HERNDON AVE STE 105
FRESNO CA
93720-3306
US

V. Phone/Fax

Practice location:
  • Phone: 559-450-5379
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number116227
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: