Provider Demographics
NPI:1659375566
Name:DONOHOE, TODD ALAN (DC, DICCP)
Entity Type:Individual
Prefix:DR
First Name:TODD
Middle Name:ALAN
Last Name:DONOHOE
Suffix:
Gender:M
Credentials:DC, DICCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41880 KALMIA ST
Mailing Address - Street 2:SUITE 135
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92562-8825
Mailing Address - Country:US
Mailing Address - Phone:951-677-6500
Mailing Address - Fax:951-677-2665
Practice Address - Street 1:41880 KALMIA ST
Practice Address - Street 2:SUITE 135
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92562-8825
Practice Address - Country:US
Practice Address - Phone:951-677-6500
Practice Address - Fax:951-677-2665
Is Sole Proprietor?:No
Enumeration Date:2005-06-08
Last Update Date:2013-12-09
Deactivation Date:2006-03-21
Deactivation Code:
Reactivation Date:2006-03-31
Provider Licenses
StateLicense IDTaxonomies
CADC26378111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAU75506Medicare UPIN
DC0263780Medicare ID - Type Unspecified