Timothy Richardson
Dermatologist Procedural Dermatology MOHS-Micrographic Surgeon
36867 Cook St Suite 101
Palm Desert
, California 92211-6064
Timothy Richardson
Dermatologist Procedural Dermatology MOHS-Micrographic Surgeon
36867 Cook St Suite 101
Palm Desert
, California 92211-6064
(760) 341-1997
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About
Features
Specialties
- Dermatologist
- MOHS-Micrographic Surgeon
- Procedural Dermatology
Languages spoken
- English
Location
First Address
- Timothy Richardson
- Po Box 1486
- Rancho Mirage, CA
- Zip : 92270-1049
- Fax : (760) 341-1997
- Phone : (760) 341-1999
Second Address
- Timothy Richardson
- 36867 Cook St Suite 101
- Palm Desert, CA
- Zip : 92211-6064
- Fax : (760) 341-1997
- Phone : (760) 341-1999
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 207N00000X | Dermatologist | G53073 | CA |
| Y | 207ND0101X | MOHS-Micrographic Surgeon | G53073 | CA |
| N | 207NS0135X | Procedural Dermatology | G53073 | CA |
National Provider Identifier
| NPI | 1164446548 |
|---|---|
| Provider Name | Timothy Richardson |
| First Address | Rancho Mirage, CA 92270-1049 |
| Second Address | Palm Desert, CA 92211-6064 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 27/07/2006 |
| Last Update Date | 14/09/2020 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| E24193 | (02) | CA |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.