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General NPI Number Information
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NPI Number | 1699780106
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Entity Type | Individual
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Provider Name | JORGE ENRIQUE TOLOSA MD, MSCE
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Gender | Male
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Dates
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Enumeration Date | 07/31/2006
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Last Update Date | 06/05/2020
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Provider Practice Location Address
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Address Line | 701 OSTRUM ST STE 303
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City | FOUNTAIN HILL
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State | PA
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Zip | 18015
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Country | US
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Telephone | 503-494-2101
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Fax | 866-410-7401
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Provider Business Mailing Address
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Address Line | 701 OSTRUM ST STE 303
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City | FOUNTAIN HILL
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State | PA
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Zip | 18015-1152
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Country | US
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Telephone | 484-526-3900
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Fax | 866-410-7401
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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 | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | MD25459
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | MD00048485
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License Number State | WA
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Taxonomy #3
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Taxonomy Code | 207VM0101X
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Taxonomy Name | Maternal & Fetal Medicine Physician
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License Number | MD25459
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License Number State | OR
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Taxonomy #4
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Taxonomy Code | 207VM0101X
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Taxonomy Name | Maternal & Fetal Medicine Physician
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License Number | MD00048485
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License Number State | WA
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Taxonomy #5
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Taxonomy Code | 207VM0101X
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Taxonomy Name | Maternal & Fetal Medicine Physician
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License Number | MD065192L
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License Number State | PA
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