Healthcare Provider Details

I. General information

NPI: 1982113577
Provider Name (Legal Business Name): WILLIAM R TODD DPM- NINA S TODD DPM INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/26/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1511 CLEMENT ST
SAN FRANCISCO CA
94118-1031
US

IV. Provider business mailing address

1511 CLEMENT ST
SAN FRANCISCO CA
94118-1031
US

V. Phone/Fax

Practice location:
  • Phone: 415-387-5556
  • Fax: 415-387-2424
Mailing address:
  • Phone: 415-387-5556
  • Fax: 415-387-2424

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberE2155
License Number StateCA

VIII. Authorized Official

Name: DR. WILLIAM R TODD
Title or Position: OWNER
Credential: DPM
Phone: 415-387-5556