Provider Demographics
NPI:1548346034
Name:TOTH, JOHN RICHARD (DO)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:RICHARD
Last Name:TOTH
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2270 BACON ST
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94520-2022
Mailing Address - Country:US
Mailing Address - Phone:925-687-9447
Mailing Address - Fax:925-687-9483
Practice Address - Street 1:2270 BACON ST
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94520-2022
Practice Address - Country:US
Practice Address - Phone:925-687-9447
Practice Address - Fax:925-687-9483
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A5692207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAF33377Medicare UPIN
CA020A56920Medicare ID - Type Unspecified