Mirage Dermatology Medical Associates, Inc.

LBN: Timothy F. Richardson, M.D., A Medical Corporation
Mirage Dermatology Medical Associates, Inc. is an health care organization with primary practice located at 36867 Cook St Suite 101, Palm Desert CA 92211-6064. The organization recently has only one registered license in Ambulatory Health Care Facilities / Medical Specialty, which is considered as the primary health care specialty. Timothy F. Richardson, M.D., A Medical Corporation can be contacted via phone (760) 341-1999, or through Richardson, Timothy via phone (760) 341-1999.

Contact Information

Primary practice address
36867 Cook St Suite 101 Palm Desert CA 92211-6064
Phone: (760) 341-1999
Fax: (760) 341-1997
Website:
Map and Directions
Authorized official contact:
Name: Richardson, Timothy Doctor of Medicine (MD)
Phone: (760) 341-1999

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Medical Specialty 261QM2500X G53073 California

Profile Details

NPI number 1346262375
LBN Legal business name Timothy F. Richardson, M.D., A Medical Corporation
DBA Doing business as Mirage Dermatology Medical Associates, Inc.
Authorized official Richardson, Timothy Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Jul 25th, 2006
Last updated Jun 28th, 2021 - about 4 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1346262375 NPPES
California Other ZZZ23174Z MEDICARE PTAN

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