Healthcare Provider Details
I. General information
NPI: 1427177807
Provider Name (Legal Business Name): TODD FHILIPH DEUTSCH M.A.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 03/28/2007
Last Update Date: 02/03/2014
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
10350 SANTA MONICA BLVD SUITE 310
LOS ANGELES CA
90025-5055
US
IV. Provider business mailing address
1200 WILSHIRE BLVD SUITE 500
LOS ANGELES CA
90017-1908
US
V. Phone/Fax
- Phone: 919-887-8550
- Fax:
- Phone: 213-481-4260
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 106H00000X |
| Taxonomy | Marriage & Family Therapist |
| License Number | MFC45924 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: