Provider Demographics
NPI:1427484088
Name:TOKOLAHI, FATAI
Entity type:Individual
Prefix:MR
First Name:FATAI
Middle Name:
Last Name:TOKOLAHI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:295 CECILIA WAY
Mailing Address - Street 2:
Mailing Address - City:TIBURON
Mailing Address - State:CA
Mailing Address - Zip Code:94920-2038
Mailing Address - Country:US
Mailing Address - Phone:415-879-0031
Mailing Address - Fax:
Practice Address - Street 1:295 CECILIA WAY
Practice Address - Street 2:
Practice Address - City:TIBURON
Practice Address - State:CA
Practice Address - Zip Code:94920-2038
Practice Address - Country:US
Practice Address - Phone:415-879-0031
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-16
Last Update Date:2013-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker