Provider Demographics
NPI:1376523134
Name:TODD, NINA SHLIAPNIKOFF (DPM)
Entity Type:Individual
Prefix:
First Name:NINA
Middle Name:SHLIAPNIKOFF
Last Name:TODD
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1511 CLEMENT ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94118-1031
Mailing Address - Country:US
Mailing Address - Phone:415-387-5556
Mailing Address - Fax:415-387-2424
Practice Address - Street 1:1511 CLEMENT ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94118-1031
Practice Address - Country:US
Practice Address - Phone:415-387-5556
Practice Address - Fax:415-387-2424
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-18
Last Update Date:2008-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE2155213EP1101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA000E21550Medicaid
CA000E21550Medicaid
CAT11206Medicare UPIN
000E21551Medicare PIN
000E21550Medicare PIN