Roberts, Timothy
Roberts, Timothy is an individual health care provider with primary practice located at 11234 Anderson St , Loma Linda CA 92354-2804. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as his primary health care specialty. Roberts, Timothy can be contacted via phone (909) 558-4475.Contact Information
Primary practice address
11234 Anderson St
Loma Linda CA 92354-2804
Phone: (909) 558-4475
Fax:
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered | 367500000X | 657663 | Texas |
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered | 367500000X | 95001006 | California |
Profile Details
NPI number | 1245293810 |
---|---|
LBN Legal business name | Roberts, Timothy |
Credentials | |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Apr 6th, 2006 |
Last updated | Apr 6th, 2022 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1245293810 | NPPES |
Texas | MEDICAID | 1578585-02 | |
Texas | Other | P00198584 | |
Texas | Other | 84441U |
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