Basic Information
| Provider Information | |||||||||
| NPI: | 1114998077 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | TOH | ||||||||
| FirstName: | ROGELIO | ||||||||
| MiddleName: | TAN | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 12089 | ||||||||
| Address2: | |||||||||
| City: | SAN BERNARDINO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 924232089 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9093354148 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1850 N RIVERSIDE AVE | ||||||||
| Address2: | SUITE 240 | ||||||||
| City: | RIALTO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 923768071 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9094212700 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/30/2006 | ||||||||
| LastUpdateDate: | 02/18/2009 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | C43085 | CA | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.