Provider Demographics
NPI:1306158381
Name:TOSI, JOAQUIN (MD)
Entity type:Individual
Prefix:DR
First Name:JOAQUIN
Middle Name:
Last Name:TOSI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:410 SOLANO DR SE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87108-2652
Mailing Address - Country:US
Mailing Address - Phone:718-310-0664
Mailing Address - Fax:
Practice Address - Street 1:1 UNIVERSITY OF NEW MEXICO
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87131-0001
Practice Address - Country:US
Practice Address - Phone:718-310-0664
Practice Address - Fax:505-272-4054
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-08
Last Update Date:2017-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM#MD2016-0138207W00000X
MI4301097034207W00000X, 207WX0107X
NMMD2016-0138207WX0107X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM#MD2016-0138OtherNEW MEXICO MEDICAL BOARD
MI4301097034OtherMEDICAL LICENSE