Provider Demographics
NPI:1700904893
Name:HUXFORD, TIM R (CPRP)
Entity Type:Individual
Prefix:
First Name:TIM
Middle Name:R
Last Name:HUXFORD
Suffix:
Gender:M
Credentials:CPRP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:340 N MADISON AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90004-3504
Mailing Address - Country:US
Mailing Address - Phone:323-644-2246
Mailing Address - Fax:323-297-1942
Practice Address - Street 1:340 N MADISON AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90004-3504
Practice Address - Country:US
Practice Address - Phone:323-644-2246
Practice Address - Fax:323-297-1942
Is Sole Proprietor?:No
Enumeration Date:2007-03-27
Last Update Date:2017-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner