Provider Demographics
NPI:1023105343
Name:RAND, TIMOTHY C (MD)
Entity type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:C
Last Name:RAND
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3851 KATELLA AVE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:LOS ALAMITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90720-3338
Mailing Address - Country:US
Mailing Address - Phone:562-431-5000
Mailing Address - Fax:562-431-5534
Practice Address - Street 1:3851 KATELLA AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:LOS ALAMITOS
Practice Address - State:CA
Practice Address - Zip Code:90720-3309
Practice Address - Country:US
Practice Address - Phone:562-431-5000
Practice Address - Fax:562-431-5534
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2016-10-11
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA41179207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA41179OtherSTATE MEDICAL LICENSE
CAA41179OtherSTATE MEDICAL LICENSE
CAW19764Medicare ID - Type UnspecifiedMEDICARE GROUP NUMBER
CA20-2591036OtherTAX ID