Theodore Edmund Staahl, M.D.

NPI #1295896041 in Modesto, California

Provider Information

NPI Number: 1295896041
Entity Type: Individual
Name: Theodore Edmund Staahl, M.D.
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Specialist
Credential: M.D.
Enumeration Date: Dec 13, 2006
Last Updated: Jul 9, 2007

Practice Location

Address: 1329 SPANOS CT STE A-1
City: Modesto
State: California
ZIP Code: 95355-2806
Phone: (209) 577-5700

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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