Provider Demographics
NPI:1083748461
Name:JOCHEN, TIMOTHY MARK (MD)
Entity Type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:MARK
Last Name:JOCHEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42600 MIRAGE RD BLDG A1
Mailing Address - Street 2:
Mailing Address - City:RANCHO MIRAGE
Mailing Address - State:CA
Mailing Address - Zip Code:92270-4127
Mailing Address - Country:US
Mailing Address - Phone:760-423-4000
Mailing Address - Fax:760-318-8103
Practice Address - Street 1:42600 MIRAGE RD
Practice Address - Street 2:BLDG A1
Practice Address - City:RANCHO MIRAGE
Practice Address - State:CA
Practice Address - Zip Code:92270-4127
Practice Address - Country:US
Practice Address - Phone:760-416-6971
Practice Address - Fax:760-318-8103
Is Sole Proprietor?:No
Enumeration Date:2007-03-15
Last Update Date:2020-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA70216207N00000X, 207ND0101X, 207NS0135X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural Dermatology
No207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA070017415Medicare PIN
CA00A702160Medicare ID - Type UnspecifiedMEDICARE PPIN
CAG35206Medicare UPIN
CAZZZ23608ZMedicare ID - Type UnspecifiedMEDICARE GROUP ID