Provider Demographics
NPI:1720181647
Name:FORSTER, TODD ANTHONY (PA-C)
Entity Type:Individual
Prefix:MR
First Name:TODD
Middle Name:ANTHONY
Last Name:FORSTER
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5251 VIEWRIDGE CT
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92123-1612
Mailing Address - Country:US
Mailing Address - Phone:858-266-6553
Mailing Address - Fax:858-266-6593
Practice Address - Street 1:754 MEDICAL CENTER CT
Practice Address - Street 2:STE. #204
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91911-6654
Practice Address - Country:US
Practice Address - Phone:619-616-2100
Practice Address - Fax:619-616-2104
Is Sole Proprietor?:No
Enumeration Date:2006-09-06
Last Update Date:2021-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA17441363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical