Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225000000X | Orthotic Fitter |
NPI | 1073995932 |
---|---|
Provider Name | Richard William Todd |
First Address | Pleasant Hill, CA 94523-4650 |
Second Address | Pleasant Hill, CA 94523-4650 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/06/2015 |
Last Update Date | 26/06/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
7502 | DR. COMFORT SHOES (01) | CA |
C17990 | BOARD OF CERTIFICATION /ACCREDITATION, INTERNATIONAL (01) | CA |
CFO00238 | AMERICAN BOARD OF ORTHOTICS AND PROSTHETICS (01) | CA |