Individual
TRAVIS LOIDOLT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
584 N SUNRISE AVE STE 100, ROSEVILLE, CA 95661-2862
(916) 800-4685
(916) 512-3901
Mailing address
2220 E BIDWELL ST, FOLSOM, CA 95630-3463
(916) 800-4685
(916) 512-3901
Taxonomy
Speciality
Code
Description
License number
State
207XS0117X
Orthopaedic Surgery of the Spine Physician
Primary
20A16495
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20A16495
CA MED LICENSE
CA
Enumeration date
04/20/2012
Last updated
02/17/2023
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