Provider Demographics
NPI:1811016736
Name:FRIGARD, TODD M (DC)
Entity Type:Individual
Prefix:
First Name:TODD
Middle Name:M
Last Name:FRIGARD
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 W 3RD ST
Mailing Address - Street 2:
Mailing Address - City:ANTIOCH
Mailing Address - State:CA
Mailing Address - Zip Code:94509-1275
Mailing Address - Country:US
Mailing Address - Phone:925-754-1441
Mailing Address - Fax:925-754-0897
Practice Address - Street 1:501 W 3RD ST
Practice Address - Street 2:
Practice Address - City:ANTIOCH
Practice Address - State:CA
Practice Address - Zip Code:94509-1275
Practice Address - Country:US
Practice Address - Phone:925-754-1441
Practice Address - Fax:925-754-0893
Is Sole Proprietor?:No
Enumeration Date:2007-03-29
Last Update Date:2007-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA18012111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
U31366Medicare UPIN
CADC0180120Medicare PIN