Healthcare Provider Details

I. General information

NPI: 1598991689
Provider Name (Legal Business Name): TOAD HALL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/03/2009
Last Update Date: 06/03/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

369 PINE ST STE 422
SAN FRANCISCO CA
94104-3310
US

IV. Provider business mailing address

369 PINE ST STE 422
SAN FRANCISCO CA
94104-3310
US

V. Phone/Fax

Practice location:
  • Phone: 415-788-4128
  • Fax: 415-788-4180
Mailing address:
  • Phone: 415-788-4128
  • Fax: 415-788-4180

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207KA0200X
TaxonomyAllergy Physician
License NumberG13859
License Number StateCA

VIII. Authorized Official

Name: DR. MICHAEL J REID
Title or Position: OWNER
Credential: M.D.
Phone: 415-788-4128