Healthcare Provider Details

I. General information

NPI: 1871712778
Provider Name (Legal Business Name): TODD HOWARD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/25/2007
Last Update Date: 06/14/2023
Certification Date: 06/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15116 S, GIBSON AVENUE
RANCHO DOMINGUEZ CA
90220
US

IV. Provider business mailing address

15116 S, GIBSON AVENUE
RANCHO DOMINGUEZ CA
90220
US

V. Phone/Fax

Practice location:
  • Phone: 323-242-5000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: