Provider Demographics
NPI:1518947506
Name:HILL, TODD PRESTON (DO)
Entity Type:Individual
Prefix:
First Name:TODD
Middle Name:PRESTON
Last Name:HILL
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22421 DE GRASSE DR
Mailing Address - Street 2:
Mailing Address - City:CALABASAS
Mailing Address - State:CA
Mailing Address - Zip Code:91302-5117
Mailing Address - Country:US
Mailing Address - Phone:816-812-8610
Mailing Address - Fax:870-907-0707
Practice Address - Street 1:1101 N SEPULVEDA BLVD STE 201
Practice Address - Street 2:
Practice Address - City:MANHATTAN BEACH
Practice Address - State:CA
Practice Address - Zip Code:90266-5963
Practice Address - Country:US
Practice Address - Phone:877-859-2341
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-18
Last Update Date:2023-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20020105802084P0800X
ARE-159262084P0800X
KS05296822084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
34354034OtherBCBS
MOP00410837OtherMEDICARE RAILROAD
MOP00410837OtherMEDICARE RAILROAD
MOW20C684Medicare PIN