Healthcare Provider Details

I. General information

NPI: 1528990496
Provider Name (Legal Business Name): TOMA PUIG
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/02/2026
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

746 N GARFIELD AVE APT 4
PASADENA CA
91104-4263
US

IV. Provider business mailing address

746 N GARFIELD AVE APT 4
PASADENA CA
91104-4263
US

V. Phone/Fax

Practice location:
  • Phone: 951-269-1903
  • Fax: 951-269-1903
Mailing address:
  • Phone: 951-269-1903
  • Fax: 951-269-1903

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: