Basic Information
| Provider Information | |||||||||
| NPI: | 1538259304 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FORD | ||||||||
| FirstName: | LLOYD | ||||||||
| MiddleName: | C | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2637 SHADELANDS DR | ||||||||
| Address2: | |||||||||
| City: | WALNUT CREEK | ||||||||
| State: | CA | ||||||||
| PostalCode: | 945982512 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9259488143 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 2700 GRANT STREET | ||||||||
| Address2: | SUITE 104 | ||||||||
| City: | CONCORD | ||||||||
| State: | CA | ||||||||
| PostalCode: | 94520 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9256857400 | ||||||||
| FaxNumber: | 9256850917 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/13/2006 | ||||||||
| LastUpdateDate: | 09/18/2017 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Y00000X | A65009 | CA | Y | Allopathic & Osteopathic Physicians | Otolaryngology | 207YX0602X | A65009 | CA | N | Allopathic & Osteopathic Physicians | Otolaryngology | Otolaryngic Allergy |
ID Information
| ID | Type | State | Issuer | Description | A65009 | 01 | CA | LICENSE | OTHER |