Healthcare Provider Details

I. General information

NPI: 1285261578
Provider Name (Legal Business Name): MORKEH BLAY-TOFEY MD, MBA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/25/2020
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2448 GUERNEVILLE RD STE 800
SANTA ROSA CA
95403-7228
US

IV. Provider business mailing address

2448 GUERNEVILLE RD STE 800
SANTA ROSA CA
95403-7228
US

V. Phone/Fax

Practice location:
  • Phone: 801-682-6148
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberT2561
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMD500002860
License Number StateDC
# 3
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberA204210
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: