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General NPI Number Information
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NPI Number | 1255316626
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Entity Type | Individual
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Provider Name | TODD S ANHALT MD
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Gender | Male
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Dates
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Enumeration Date | 12/08/2005
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Last Update Date | 01/27/2009
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Provider Practice Location Address
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Address Line | 129 FREMONT AVE
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City | LOS ALTOS
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State | CA
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Zip | 94022-3956
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Country | US
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Telephone | 650-917-7711
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Fax | 650-917-7712
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Provider Business Mailing Address
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Address Line | 129 FREMONT AVE
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City | LOS ALTOS
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State | CA
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Zip | 94022-3956
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Country | US
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Telephone | 650-917-7711
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Fax | 650-917-7712
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | G53965
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207NP0225X
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Taxonomy Name | Pediatric Dermatology Physician
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License Number | G53965
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 207ND0900X
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Taxonomy Name | Dermatopathology Physician
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License Number | G53965
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 207NI0002X
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Taxonomy Name | Clinical & Laboratory Dermatological Immunology Physician
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License Number | G53965
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License Number State | CA
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Taxonomy #5
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Taxonomy Code | 207NS0135X
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Taxonomy Name | Procedural Dermatology Physician
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License Number | G53965
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License Number State | CA
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