Provider Demographics
NPI:1467405241
Name:MIHOK, TED FRANCIS (DPM)
Entity Type:Individual
Prefix:MR
First Name:TED
Middle Name:FRANCIS
Last Name:MIHOK
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2059 CLINTON AVE
Mailing Address - Street 2:
Mailing Address - City:ALAMEDA
Mailing Address - State:CA
Mailing Address - Zip Code:94501-4379
Mailing Address - Country:US
Mailing Address - Phone:510-865-2500
Mailing Address - Fax:
Practice Address - Street 1:2059 CLINTON AVE
Practice Address - Street 2:
Practice Address - City:ALAMEDA
Practice Address - State:CA
Practice Address - Zip Code:94501-4379
Practice Address - Country:US
Practice Address - Phone:510-865-2500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-19
Last Update Date:2008-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA2046213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAT10164Medicare UPIN