Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | A90955 | CA |
NPI | 1053436550 |
---|---|
Provider Name | Timothy F. Lesser |
First Address | Torrance, CA 90503-4352 |
Second Address | Torrance, CA 90503 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/03/2007 |
Last Update Date | 31/05/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
P00647441 | MEDICARE GROUP PTAN (01) | CA |