NPI: 1346262375
Provider Name: TIMOTHY F. RICHARDSON, M.D., A MEDICAL CORPORATION
Doing Business As: MIRAGE DERMATOLOGY MEDICAL ASSOCIATES, INC.
Classification: Clinic/Center - 261QM2500X
Entity Type: Organization
Specialization: Medical Specialty
CLIA Number: 05D0930533
Address:
36867 COOK ST
SUITE 101
PALM DESERT, CA
ZIP 92211
Phone: (760) 341-1999
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TIMOTHY F. RICHARDSON, M.D., A MEDICAL CORPORATION is a medical specialty clinic center in Palm Desert, CA. The provider is an entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer). TIMOTHY F. RICHARDSON, M.D., A MEDICAL CORPORATION NPI is 1346262375. The provider is registered as an organization entity type.
The provider Is Doing Business As Mirage Dermatology Medical Associates, Inc..
The provider's business location address is:
36867 COOK ST
SUITE 101
PALM DESERT, CA
ZIP 92211-064
Phone: (760) 341-1999
Fax: (760) 341-1997
The provider's authorized official is Timothy Richardson .
The authorized official title is President and has the following contact phone number (760) 341-1999.
The CLIA number assigned to this NPI record is 05D0930533 - physician office with a certificate type of Certificate of Compliance.
The enumeration date for this NPI number is 7/25/2006 and was last updated on 6/28/2021.