Provider Demographics
NPI:1003020223
Name:TODD, DAVID P JR (OD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:P
Last Name:TODD
Suffix:JR
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2765 LEXINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:MERCED
Mailing Address - State:CA
Mailing Address - Zip Code:95340-3388
Mailing Address - Country:US
Mailing Address - Phone:561-213-7583
Mailing Address - Fax:
Practice Address - Street 1:19270 HIGHWAY 12
Practice Address - Street 2:
Practice Address - City:SONOMA
Practice Address - State:CA
Practice Address - Zip Code:95476-5414
Practice Address - Country:US
Practice Address - Phone:707-939-6070
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-09
Last Update Date:2025-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC3189152W00000X
VA0618001915152W00000X, 207W00000X
CA14252152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA14252TPGLOtherSTATE OPTOMETRY LICENSE
FL20796Medicare ID - Type Unspecified