Provider Demographics
NPI:1598991689
Name:TOAD HALL INC
Entity Type:Organization
Organization Name:TOAD HALL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:REID
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:415-788-4128
Mailing Address - Street 1:369 PINE ST STE 422
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94104-3310
Mailing Address - Country:US
Mailing Address - Phone:415-788-4128
Mailing Address - Fax:415-788-4180
Practice Address - Street 1:369 PINE ST STE 422
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94104-3310
Practice Address - Country:US
Practice Address - Phone:415-788-4128
Practice Address - Fax:415-788-4180
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-03
Last Update Date:2009-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG13859207KA0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G13859Medicare PIN