Individual
JOSIAH TO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD, MASC
Contact information
Practice address
1950 W POLK ST # 5L175-1, CHICAGO, IL 60612-3723
(312) 864-0395
Mailing address
18692 CAMINITO CANTILENA UNIT 216, SAN DIEGO, CA 92128-6103
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
125.079982
IL
Other
Enumeration date
06/06/2022
Last updated
06/06/2022
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