TIMOTHY F. RICHARDSON, M.D., A MEDICAL CORPORATION (NPI# 1346262375) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346262375 |
| Entity Type | Organization |
| Organization Name | TIMOTHY F. RICHARDSON, M.D., A MEDICAL CORPORATION |
| Other Organization Name | MIRAGE DERMATOLOGY MEDICAL ASSOCIATES, INC. |
| Practice Address |
36867 Cook St Suite 101 Palm Desert CA 92211-6064 |
| Mailing Address |
Po Box 1486 Rancho Mirage CA 92270-1049 |
| Practice Telephone | 7603411999 |
| Practice Fax Number | 7603411997 |
| Mailing Telephone | 7603411999 |
| Mailing Fax Number | 7603411997 |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2013-07-02 |
| Authorized Official Name | DR. TIMOTHY RICHARDSON (PRESIDENT) |
| Authorized Official Telephone | 7603411999 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM2500X |
Clinic/Center Specialization: Medical Specialty |
G53073 | CA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | MEDICARE PTAN | ZZZ23174Z | 01 |
| Other Name | Type Code |
|---|---|
| Mirage Dermatology Medical Associates, Inc. | Doing Business As Name - Organization |
| Street Address |
36867 COOK ST SUITE 101 |
| City | PALM DESERT |
| State | CA |
| Zip Code | 92211-6064 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588964183 | Cynthia Richardson | Nurse Practitioner | 36867 Cook St, Suite 101, Palm Desert, CA 92211-6064 | 2010-10-28 |
| 1942516737 | B. Maya Kato, Md, A Professional Corporation | Otolaryngology | 36867 Cook St, Suite 103, Palm Desert, CA 92211-6064 | 2010-08-31 |
| 1003991761 | B. Maya Kato | Otolaryngology | 36867 Cook St, Suite 103, Palm Desert, CA 92211-6064 | 2006-10-25 |
| 1164446548 | Timothy Richardson | Dermatology | 36867 Cook St, Suite 101, Palm Desert, CA 92211-6064 | 2006-07-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780293936 | Childnet Youth and Family Services, Inc. | Community/Behavioral Health | 42-600 Cook Street, Suite 100, Palm Desert, CA 92211 | 2020-07-23 |
| 1003457607 | Catherine Krumplitsch | Technician | 41430 Kansas Street, Palm Desert, CA 92211 | 2019-10-04 |
| 1942702055 | Executive Recovery Group, Inc | Clinic/Center | 77725 Enfield Ln # 100-200, Palm Desert, CA 92211 | 2018-03-05 |
| 1992248918 | West Coast Surgery Inc | Orthopaedic Surgery | 36915 Cook Street, Suite 103 B, Palm Desert, CA 92211 | 2016-11-22 |
| 1063963098 | Therese Tudor | Physical Therapist | 77-682 Country Club Drive, Suite G, Palm Desert, CA 92211 | 2016-10-14 |
| 1609249663 | John D Rasmussen | Anesthesiology | 160 Running Spring Drive, Palm Desert, CA 92211 | 2015-11-12 |
| 1033580113 | Executive Recovery Group, Inc | Substance Abuse Rehabilitation Facility | 35450 Pegasus Ct, Palm Desert, CA 92211 | 2015-10-14 |
| 1861862146 | Artur Sarkisyan | Dentist | 34-460 Monterey Ave Ste 100, Palm Desert, CA 92211 | 2015-09-30 |
| 1649686833 | Annamaria Valenzuela | Licensed Vocational Nurse | 77-777 Country Club Drive, Apt 235, Palm Desert, CA 92211 | 2014-07-08 |
| 1265876759 | Guardian Angel Home Care, Inc. | Home Health | 41865 Boardwalk, Suite 215, Palm Desert, CA 92211 | 2013-04-26 |
| Find all providers in zip 92211 | ||||
| Taxonomy Code | 261QM2500X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Medical Specialty |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer). |
| Notes: [7/1/2003: new] |
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| 1003440884 | La Laser Center PC, A Professional Medical Corporation | Clinic/Center | 300 Old River Rd Ste 120, Bakersfield, CA 93311-9512 | 2020-03-02 |
| 1083247795 | La Laser Center PC, A Professional Medical Corporation | Clinic/Center | 1025 N Demaree St, Visalia, CA 93291-4117 | 2020-02-20 |
| 1780217489 | La Laser Center PC, A Professional Medical Corporation | Clinic/Center | 621 W Line St Ste 105, Bishop, CA 93514-3320 | 2020-02-20 |
| Find all providers with the same taxonomy | ||||
| City | PALM DESERT |
| Zip Code | 92211 |
Please comment or provide details below to improve the information on TIMOTHY F. RICHARDSON, M.D., A MEDICAL CORPORATION.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.