Provider Demographics
NPI:1407145931
Name:ALMAZAN, TIMOTHY HERMOSURA (MD)
Entity Type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:HERMOSURA
Last Name:ALMAZAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:14445 OLIVE VIEW DRIVE
Mailing Address - Street 2:
Mailing Address - City:SYLMAR
Mailing Address - State:CA
Mailing Address - Zip Code:91342
Mailing Address - Country:US
Mailing Address - Phone:747-210-3205
Mailing Address - Fax:747-210-4573
Practice Address - Street 1:OLIVE VIEW. UCLA MED. CTR
Practice Address - Street 2:14445 OLIVE VIEW DRIVE
Practice Address - City:SYLMAR
Practice Address - State:CA
Practice Address - Zip Code:91342
Practice Address - Country:US
Practice Address - Phone:747-210-3205
Practice Address - Fax:747-210-4573
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-05
Last Update Date:2021-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CAA125941207N00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine