Healthcare Provider Details

I. General information

NPI: 1730258336
Provider Name (Legal Business Name): CARLA ANN TOMS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/07/2006
Last Update Date: 05/26/2022
Certification Date: 05/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1403 LOMITA BLVD STE 102
HARBOR CITY CA
90710-2084
US

IV. Provider business mailing address

2716 MAINE AVE
LONG BEACH CA
90806-2522
US

V. Phone/Fax

Practice location:
  • Phone: 310-534-6221
  • Fax:
Mailing address:
  • Phone: 323-633-1645
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code173000000X
TaxonomyLegal Medicine
License NumberA81444
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA81444
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA81444
License Number StateCA
# 4
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberA81444
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: