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General NPI Number Information
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NPI Number | 1508872441
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Entity Type | Individual
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Provider Name | CHRISTOPHER TREVOR TODD MD
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Gender | Male
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Dates
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Enumeration Date | 07/31/2006
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Last Update Date | 07/17/2013
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Provider Practice Location Address
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Address Line | 2525 13TH STREET
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City | BOULDER
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State | CO
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Zip | 80304-4104
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Country | US
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Telephone | 303-449-6050
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Fax |
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Provider Business Mailing Address
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Address Line | 1345 PLAZA CT N STE 1A
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City | LAFAYETTE
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State | CO
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Zip | 80026-2832
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Country | US
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Telephone | 303-665-3036
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Fax |
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 49363
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License Number State | CO
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