Provider Demographics
NPI:1609949510
Name:HUNT, TIMOTHY J (MD)
Entity Type:Individual
Prefix:MR
First Name:TIMOTHY
Middle Name:J
Last Name:HUNT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:15901 HAWTHORNE BOULEVARD
Mailing Address - Street 2:SUITE 250
Mailing Address - City:LAWNDALE
Mailing Address - State:CA
Mailing Address - Zip Code:90260-2660
Mailing Address - Country:US
Mailing Address - Phone:310-421-0234
Mailing Address - Fax:310-370-1700
Practice Address - Street 1:15901 HAWTHORNE BOULEVARD
Practice Address - Street 2:SUITE 250
Practice Address - City:LAWNDALE
Practice Address - State:CA
Practice Address - Zip Code:90260-2660
Practice Address - Country:US
Practice Address - Phone:310-421-0234
Practice Address - Fax:310-370-1700
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-16
Last Update Date:2010-07-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG42239207X00000X
CAG82031207X00000X, 207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG42239Medicare UPIN
CAW42449BMedicare UPIN