Provider Demographics
NPI:1497985592
Name:TODOROFF MEDICAL CORPORATION
Entity Type:Organization
Organization Name:TODOROFF MEDICAL CORPORATION
Other - Org Name:UNITED PHYSICIANS GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RANDALL
Authorized Official - Middle Name:C
Authorized Official - Last Name:GREGSON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:760-630-8400
Mailing Address - Street 1:465 COLLEGE BLVD STE 1
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92057-5435
Mailing Address - Country:US
Mailing Address - Phone:760-630-8400
Mailing Address - Fax:760-630-8594
Practice Address - Street 1:465 COLLEGE BLVD STE 1
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92057-5435
Practice Address - Country:US
Practice Address - Phone:760-630-8400
Practice Address - Fax:760-630-8594
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-23
Last Update Date:2009-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty