Provider Demographics
NPI:1407145931
Name:ALMAZAN, TIMOTHY HERMOSURA (MD)
Entity type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:HERMOSURA
Last Name:ALMAZAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11900 SOUTH ST STE 118
Mailing Address - Street 2:
Mailing Address - City:CERRITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90703-6800
Mailing Address - Country:US
Mailing Address - Phone:562-800-3072
Mailing Address - Fax:760-688-0950
Practice Address - Street 1:11900 SOUTH ST STE 118
Practice Address - Street 2:
Practice Address - City:CERRITOS
Practice Address - State:CA
Practice Address - Zip Code:90703-6800
Practice Address - Country:US
Practice Address - Phone:562-800-3072
Practice Address - Fax:760-688-0950
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-05
Last Update Date:2024-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA125941207R00000X, 207N00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program