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General NPI Number Information
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NPI Number | 1568655306
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Entity Type | Individual
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Provider Name | TARA PUNDIAK TOOHEY MD
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Gender | Female
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Dates
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Enumeration Date | 08/24/2007
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Last Update Date | 10/30/2025
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Provider Practice Location Address
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Address Line | 641 CORONADO AVE
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City | CORONADO
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State | CA
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Zip | 92118-2031
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Country | US
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Telephone | 808-352-3979
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Fax |
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Provider Business Mailing Address
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Address Line | 941 ORANGE AVE # 315
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City | CORONADO
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State | CA
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Zip | 92118-2609
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Country | US
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Telephone | 808-352-3979
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 18791
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License Number State | NV
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | MD187465
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License Number State | OR
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Taxonomy #3
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 234647
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License Number State | NY
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Taxonomy #4
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | C1-0010473
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License Number State | DE
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Taxonomy #5
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 15585
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License Number State | HI
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Taxonomy #6
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | C130519
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License Number State | CA
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