Provider Demographics
NPI:1326041880
Name:YOU, TIMOTHY T (MD)
Entity Type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:T
Last Name:YOU
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 1:1200 N TUSTIN AVE
Mailing Address - Street 2:STE 140
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92705-3501
Mailing Address - Country:US
Mailing Address - Phone:714-972-8235
Mailing Address - Fax:
Practice Address - Street 1:1200 N TUSTIN AVE
Practice Address - Street 2:STE 140
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92705-3501
Practice Address - Country:US
Practice Address - Phone:714-972-8235
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-05-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG80625207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG44321Medicare UPIN