# TOTAL CARE MEDICAL GROUP LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1639502057
- **Authorized official:** JACKIE TATE (OFFIE MANAGER)
- **Authorized official phone:** (732) 451-1200

## Contact information

- **Practice address:** 1868 HOOPER AVE, TOMS RIVER, NJ 08753-8175
- **Practice address phone:** (732) 451-1200
- **Practice address fax:** (732) 864-1229
- **Mailing address:** 1868 HOOPER AVE, TOMS RIVER, NJ 08753-8175
- **Mailing address phone:** (732) 451-1200
- **Mailing address fax:** (732) 864-1229

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 204D00000X | Neuromusculoskeletal Medicine & OMM Physician | — | NULL | Yes |
| 204D00000X | Neuromusculoskeletal Medicine & OMM Physician | — | — | Yes |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | — | NULL | — |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | — | — | — |

## Other

- **Enumeration date:** 08/21/2013
- **Last updated:** 08/21/2013