Provider Demographics
NPI:1972532042
Name:TOSCANO, EDGAR P (MD)
Entity type:Individual
Prefix:DR
First Name:EDGAR
Middle Name:P
Last Name:TOSCANO
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 1:3114 W. BEVERLY BLVD
Mailing Address - Street 2:
Mailing Address - City:MONTEBELLO
Mailing Address - State:CA
Mailing Address - Zip Code:90640-2217
Mailing Address - Country:US
Mailing Address - Phone:626-797-7403
Mailing Address - Fax:626-797-7403
Practice Address - Street 1:3114 W. BEVERLY BLVD
Practice Address - Street 2:
Practice Address - City:MONTEBELLO
Practice Address - State:CA
Practice Address - Zip Code:90640-2217
Practice Address - Country:US
Practice Address - Phone:213-309-9857
Practice Address - Fax:323-872-5159
Is Sole Proprietor?:No
Enumeration Date:2006-07-01
Last Update Date:2011-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA80296207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAP00202689OtherRAILROAD
CA00A802960Medicaid
CA00A802960Medicare ID - Type UnspecifiedMEDICARE
CAI09267Medicare UPIN