MEDICARE: DR. JACQUELYN L TOTON 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	207V00000X	Obstetrics & Gynecology Physician	G22870	CA
2	207V00000X	Obstetrics & Gynecology Physician	12880	HI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1720093123
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JACQUELYN L TOTON M.D.

Provider Business Mailing Address
First Line	:	12150 GOLD STRIKE RD
Second Line	:
City	:	PINE GROVE
State	:	CA
Zip	:	95665-9766
Country	:	US
Telephone Number	:	209-296-2382
Fax Number	:

Provider Business Practice Location Address
First Line	:	4021 S 700 E
Second Line	:	SUITE 300
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84107-2192
Country	:	US
Telephone Number	:	800-328-3067
Fax Number	:

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

Provider Enumeration Date	:	07/31/2006
Last Update Date	:	09/11/2025

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