Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Theodore Edmund Staahl, MD

Individual provider Specialist · NPI 1295896041

Theodore Edmund Staahl, MD is an Otolaryngology in Modesto, California. Qualified in 1971, 55 years ago. Practices as a sole proprietor and accepts Medicare assignment. Licensed in California.

Years since qualifying
55
Licensed in
CA
In the registry since
2006
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

1329 Spanos Ct Ste A-1
Modesto, CA 95355-2806
Phone: (209) 577-5700
Fax: (209) 577-5968
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Specialist (primary) Taxonomy 174400000X · Licence G037452 (CA)

Record details

NPI number1295896041
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorYes
NPI enumeratedDecember 13, 2006
Last updated in NPPESJuly 9, 2007

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyOTOLARYNGOLOGY
Medical schoolOTHER
Graduated 1971 (55 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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