Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XX0005X | Sports Medicine Orthopaedic Surgeon | G060834 | CA |
NPI | 1225052681 |
---|---|
Provider Name | Laura A. Timmerman |
First Address | Walnut Creek, CA 94598 |
Second Address | Walnut Creek, CA 94598 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/07/2006 |
Last Update Date | 26/05/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E81222 | (02) |