Sullivan, Timothy Joseph

Sullivan, Timothy Joseph is an individual health care provider with primary practice located at 2621 Manhattan Beach Blvd , Redondo Beach CA 90278-1604. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as his primary health care specialty. Sullivan, Timothy Joseph can be contacted via phone (310) 374-0477.

Contact Information

Primary practice address
2621 Manhattan Beach Blvd Redondo Beach CA 90278-1604
Phone: (310) 374-0477
Fax: (310) 374-1605
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X PT23153 California

Profile Details

NPI number 1760496392
LBN Legal business name Sullivan, Timothy Joseph
Credentials Physical Therapist (PT)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 28th, 2006
Last updated Jun 4th, 2024 - about 6 months 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1760496392 NPPES
California Other PT23153 PHYSICAL THERAPY LICENSE

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