Provider Demographics
NPI:1245650985
Name:DRIVER, TODD
Entity type:Individual
Prefix:
First Name:TODD
Middle Name:
Last Name:DRIVER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 CORPORATE PARK STE 150
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92606-5172
Mailing Address - Country:US
Mailing Address - Phone:949-653-9500
Mailing Address - Fax:949-653-9513
Practice Address - Street 1:9 CORPORATE PARK STE 150
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92606-5172
Practice Address - Country:US
Practice Address - Phone:949-653-9500
Practice Address - Fax:949-653-9513
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-21
Last Update Date:2023-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA140821207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology