Healthcare Provider Details

I. General information

NPI: 1205990140
Provider Name (Legal Business Name): STEVEN DOUGLAS TOMAN O.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/21/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34800 BOB WILSON DR NMCSD
SAN DIEGO CA
92134-1098
US

IV. Provider business mailing address

PO BOX 80396
SAN DIEGO CA
92138-0396
US

V. Phone/Fax

Practice location:
  • Phone: 619-524-5515
  • Fax:
Mailing address:
  • Phone: 619-524-5515
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152WC0802X
TaxonomyCorneal and Contact Management Optometrist
License Number8911 TPA
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: