Individual
DR. TODD C SELF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
940 SYLVA LN STE E, SONORA, CA 95370-5969
(209) 533-3996
(209) 533-3998
Mailing address
940 SYLVA LN STE E, SONORA, CA 95370-5969
(209) 533-3996
(209) 533-3998
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
E3690
CA
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
E3690
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000E36900
—
CA
Enumeration date
02/28/2006
Last updated
03/07/2023
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