Provider Demographics
NPI:1265604821
Name:GARONE, TIM LEO
Entity type:Individual
Prefix:
First Name:TIM
Middle Name:LEO
Last Name:GARONE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P. O. BOX 40971
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93384
Mailing Address - Country:US
Mailing Address - Phone:661-321-9023
Mailing Address - Fax:661-321-9083
Practice Address - Street 1:217 MOUNT VERNON AVE #3
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93307-2749
Practice Address - Country:US
Practice Address - Phone:661-321-9023
Practice Address - Fax:661-321-9083
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-24
Last Update Date:2010-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA08 00109917332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA6345230001Medicare NSC