Organization
TODD C SELF, DPM, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TODD C SELF DPM (OWNER)
(209) 533-3996
Entity
Organization
Contact information
Practice address
940 SYLVA LANE STE. E,, SONORA, CA 95370
(209) 533-3996
(209) 533-3998
Mailing address
940 SYLVA LANE STE. E,, SONORA, CA 95370
(209) 533-3996
(209) 533-3998
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
E3690
CA
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
E3690
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000E36900
—
CA
Enumeration date
02/01/2008
Last updated
09/28/2018
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