Healthcare Provider Details

I. General information

NPI: 1609785286
Provider Name (Legal Business Name): TOLUCA MEDICAL GROUP PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/01/2026
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10628 RIVERSIDE DR STE 2
TOLUCA LAKE CA
91602-2358
US

IV. Provider business mailing address

10628 RIVERSIDE DR STE 2
TOLUCA LAKE CA
91602-2358
US

V. Phone/Fax

Practice location:
  • Phone: 818-505-3005
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL STONE
Title or Position: OWNER
Credential: DO
Phone: 818-505-3005