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General NPI Number Information
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NPI Number | 1740227545
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Entity Type | Organization
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Legal Business Name | TOLWIN PSYCHIATRIC MEDICAL GROUP INC
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Dates
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Enumeration Date | 06/01/2006
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Last Update Date | 08/04/2021
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Provider Practice Location Address
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Address Line | 5000 OVERLAND AVE STE 108
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City | CULVER CITY
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State | CA
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Zip | 90230-4969
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Country | US
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Telephone | 310-280-9670
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Fax | 310-280-9675
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Provider Business Mailing Address
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Address Line | PO BOX 34841
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City | LOS ANGELES
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State | CA
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Zip | 90034-0841
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Country | US
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Telephone | 310-280-9670
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Fax | 310-280-9675
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Authorized Official
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Title or Position | PRESIDENT
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Name | MICHAEL TOLWIN
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Credential | M.D.
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Telephone | 310-280-9670
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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 | FNP14380
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License Number State | CA
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