Provider Demographics
NPI:1003816141
Name:ATMAJIAN, TIMOTHY KIRKOR (MD)
Entity type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:KIRKOR
Last Name:ATMAJIAN
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3030 N FRESNO ST STE 101
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93703-1100
Mailing Address - Country:US
Mailing Address - Phone:559-271-6222
Mailing Address - Fax:559-227-7668
Practice Address - Street 1:3030 N FRESNO ST STE 101
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93703-1100
Practice Address - Country:US
Practice Address - Phone:559-227-1622
Practice Address - Fax:559-227-7668
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-29
Last Update Date:2025-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG77817207R00000X
CAG778170208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA006778170Medicaid
CA006778170Medicare ID - Type Unspecified
I24605Medicare UPIN