MEDICARE: CHRISTOPHER J TOLOS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	PT 25954	CA

General Provider Information

NPI Number	:	1134179104
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTOPHER J TOLOS

Provider Business Mailing Address
First Line	:	2514 OVERLAND AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90064-3333
Country	:	US
Telephone Number	:	310-837-8001
Fax Number	:	310-837-8007

Provider Business Practice Location Address
First Line	:	2514 OVERLAND AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90064-3333
Country	:	US
Telephone Number	:	310-837-8001
Fax Number	:	310-837-8007

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/11/2006
Last Update Date	:	02/02/2015

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