Provider Demographics
NPI:1871880500
Name:TAJAV TOOMARI DO INC
Entity type:Organization
Organization Name:TAJAV TOOMARI DO INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TAJAV
Authorized Official - Middle Name:
Authorized Official - Last Name:TOOMARI
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:818-522-1818
Mailing Address - Street 1:PO BOX 573429
Mailing Address - Street 2:
Mailing Address - City:TARZANA
Mailing Address - State:CA
Mailing Address - Zip Code:91357-3429
Mailing Address - Country:US
Mailing Address - Phone:818-522-1818
Mailing Address - Fax:
Practice Address - Street 1:7100 VAN NUYS BLVD
Practice Address - Street 2:SUITE 110
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91405-3063
Practice Address - Country:US
Practice Address - Phone:818-522-1818
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-01
Last Update Date:2013-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A10433261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care