MEDICARE: DR. VICTOR T TOFAEONO MD

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	208600000X	Surgery Physician	3725	NV

General Provider Information

NPI Number	:	1194718890
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. VICTOR T TOFAEONO MD

Provider Business Mailing Address
First Line	:	P.O. BOX LBJ GENERAL DELIVERYGO
Second Line	:	LBJ TROPICAL MEDICAL CENTER
City	:	PAGO PAGO
State	:	AS
Zip	:	96799
Country	:	US
Telephone Number	:	684-633-1683
Fax Number	:	684-633-1976

Provider Business Practice Location Address
First Line	:	123 TURNER DRIVE
Second Line	:	LBJ TROPICAL MEDICAL CENTER
City	:	PAGO PAGO
State	:	AS
Zip	:	96799
Country	:	US
Telephone Number	:	684-633-1683
Fax Number	:	684-633-1976

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

Provider Enumeration Date	:	08/26/2005
Last Update Date	:	07/08/2007

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