Individual provider Active NPI

Theodric Todd, MD

  • Family Medicine Physician
  • Inglewood, CA
National Provider Identifier
1649909870
Registry record updated Sep 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A203262 Issued in CA
Practice address
110 N la Brea Ave
Inglewood, CA 90301-1708
Phone
(833) 574-2273
NPI assigned
Jun 4, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A203262 CA Primary

Addresses

Primary practice location

110 N la Brea Ave
Inglewood, CA 90301-1708

Mailing address

110 N la Brea Ave
Inglewood, CA 90301-1708
Phone (833) 574-2273

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251030004366 CA Practitioner - Family Practice 3577942069 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

393 E Walnut 3Rd FL
Pasedena, CA 91188-0001

393 E Walnut St FL
3 PHR Group Provider Enrollment Unit
Pasadena, CA 91188-0001

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A203262CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group CurrentSince Sep 15, 2025 Accepting new patients
Southern California Permanente Medical Group CurrentSince Sep 15, 2025 Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients

Locations

110 N La Brea Ave
Inglewood, CA 90301
Phone (310) 419-3324

6041 Cadillac Ave
Los Angeles, CA 90034
Phone (323) 857-2000

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1654300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756771200000",
    "number": "1649909870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 N LA BREA AVE",
            "city": "INGLEWOOD",
            "state": "CA",
            "postal_code": "903011708",
            "telephone_number": "833-574-2273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 N LA BREA AVE",
            "city": "INGLEWOOD",
            "state": "CA",
            "postal_code": "903011708",
            "telephone_number": "833-574-2273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TODD",
        "first_name": "THEODRIC",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-06-04",
        "last_updated": "2025-09-02",
        "certification_date": "2025-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A203262",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Inglewood, CA

Sources for this page

Verify at the official NPI Registry.