Provider Demographics
NPI:1134519978
Name:THOMFORDE, DAVID WOODRUFF (OTR)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:WOODRUFF
Last Name:THOMFORDE
Suffix:
Gender:M
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13554 STARBUCK ST
Mailing Address - Street 2:
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90605-2254
Mailing Address - Country:US
Mailing Address - Phone:423-333-8810
Mailing Address - Fax:
Practice Address - Street 1:13554 STARBUCK ST
Practice Address - Street 2:
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90605-2254
Practice Address - Country:US
Practice Address - Phone:423-333-8810
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-02
Last Update Date:2015-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12773225XP0019X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical Rehabilitation