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NPI Code Detail

MEDICARE: DOUGLAS EUGENE TODD M.D.

MEDICARE:   DOUGLAS EUGENE TODD  M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1174400000XSpecialistG066549CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1508856402
Entity Type Code : Individual
Provider Name (Legal Business Name) : DOUGLAS EUGENE TODD M.D.
Provider Business Mailing Address
First Line : 3156 VISTA WAY
Second Line : SUITE 405
City : OCEANSIDE
State : CA
Zip : 92056-3622
Country : US
Telephone Number : 760-439-6581
Fax Number : 760-439-6585
Provider Business Practice Location Address
First Line : 28062 BAXTER RD
Second Line :
City : MURRIETA
State : CA
Zip : 92563-1401
Country : US
Telephone Number : 951-290-4112
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/24/2005
Last Update Date : 09/04/2012

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Directions to “ DOUGLAS EUGENE TODD M.D.” Practice Location

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