Provider Demographics
NPI:1699726190
Name:TOMA, MAGED ABDELMSSIEH (MD)
Entity type:Individual
Prefix:DR
First Name:MAGED
Middle Name:ABDELMSSIEH
Last Name:TOMA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:14011 PARK AVENUE
Mailing Address - Street 2:
Mailing Address - City:VICTORVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:92392
Mailing Address - Country:US
Mailing Address - Phone:888-750-0036
Mailing Address - Fax:760-843-2045
Practice Address - Street 1:12370 HESPERIA RD
Practice Address - Street 2:SUITE 15
Practice Address - City:VICTORVILLE
Practice Address - State:CA
Practice Address - Zip Code:92395-7719
Practice Address - Country:US
Practice Address - Phone:760-241-7773
Practice Address - Fax:760-241-7793
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-12
Last Update Date:2021-11-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA89472208D00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
I20932Medicare UPIN