MEDICARE: DR. MARLIN YOUSSEF TOUMA 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	208000000X	Pediatrics Physician	BP1-0021389	TX
2	2080N0001X	Neonatal-Perinatal Medicine Physician	A116472	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	3805159129	OTHER		MYUTMB 3805159129-COMMERCIAL NUMBER
2	W11810	OTHER	CA	GROUP PTAN
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1366646952
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARLIN YOUSSEF TOUMA MD

Provider Business Mailing Address
First Line	:	5767 W CENTURY BLVD STE 400
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90045-5631
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	200 MEDICAL PLAZA SUITE 265
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90095-0462
Country	:	US
Telephone Number	:	310-825-0867
Fax Number	:

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

Provider Enumeration Date	:	06/14/2007
Last Update Date	:	07/05/2018

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