Individual
DR. TODD DANA SEVERIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5801 NORRIS CANYON RD, STE 200, SAN RAMON, CA 94583-5406
(925) 830-8823
(925) 866-6610
Mailing address
5801 NORRIS CANYON RD, STE 200, SAN RAMON, CA 94583-5440
(925) 830-8823
(925) 866-6610
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
OG711830
CA
207WX0009X
Glaucoma Specialist (Ophthalmology) Physician
G71183
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
180046438
RAIL ROAD MEDICARE
CA
05
—
OGP164916
—
CA
01
—
ZZZ057067
BLUE CROSS
CA
01
—
ZZZ05706Z
BLUE SHIELD
CA
Enumeration date
06/15/2005
Last updated
07/17/2017
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