Provider Demographics
NPI:1902273626
Name:TOBIN, LAUREL ANN
Entity Type:Individual
Prefix:MS
First Name:LAUREL
Middle Name:ANN
Last Name:TOBIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41500 WASHINGTON ST APT E223
Mailing Address - Street 2:
Mailing Address - City:BERMUDA DUNES
Mailing Address - State:CA
Mailing Address - Zip Code:92203-9516
Mailing Address - Country:US
Mailing Address - Phone:760-718-2131
Mailing Address - Fax:
Practice Address - Street 1:41500 WASHINGTON ST APT E223
Practice Address - Street 2:
Practice Address - City:BERMUDA DUNES
Practice Address - State:CA
Practice Address - Zip Code:92203-9516
Practice Address - Country:US
Practice Address - Phone:760-718-2131
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-28
Last Update Date:2015-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker