Provider Demographics
NPI:1881694107
Name:BYRON, TIMOTHY J (DPM)
Entity type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:J
Last Name:BYRON
Suffix:
Gender:M
Credentials:DPM
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Mailing Address - Street 1:26732 CROWN VALLEY PKWY
Mailing Address - Street 2:SUITE 271
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92691-6306
Mailing Address - Country:US
Mailing Address - Phone:949-364-3342
Mailing Address - Fax:949-364-2322
Practice Address - Street 1:26732 CROWN VALLEY PKWY
Practice Address - Street 2:SUITE 271
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92691-6306
Practice Address - Country:US
Practice Address - Phone:949-364-3342
Practice Address - Fax:949-364-2322
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-28
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAE1816213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAE1816Medicare ID - Type Unspecified
CAT11062Medicare UPIN