MEDICARE: DR. KAMEI TOLBA M.D.

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	207R00000X	Internal Medicine Physician	A72066	CA
2	208000000X	Pediatrics Physician	A72066	CA

General Provider Information

NPI Number	:	1144221763
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KAMEI TOLBA M.D.

Provider Business Mailing Address
First Line	:	3020 CHILDRENS WAY
Second Line	:	MC 5075
City	:	SAN DIEGO
State	:	CA
Zip	:	92123-4223
Country	:	US
Telephone Number	:	858-966-8036
Fax Number	:

Provider Business Practice Location Address
First Line	:	3020 CHILDRENS WAY
Second Line	:	MC 5075
City	:	SAN DIEGO
State	:	CA
Zip	:	92123-4223
Country	:	US
Telephone Number	:	858-966-8036
Fax Number	:

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

Provider Enumeration Date	:	08/04/2005
Last Update Date	:	02/01/2011

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