Provider Demographics
NPI:1588961106
Name:FINN, TIMOTHY (PTA)
Entity type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:
Last Name:FINN
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1515 W FLORIDA AVE
Mailing Address - Street 2:SUITE E
Mailing Address - City:HEMET
Mailing Address - State:CA
Mailing Address - Zip Code:92543-3817
Mailing Address - Country:US
Mailing Address - Phone:951-658-3121
Mailing Address - Fax:951-652-6994
Practice Address - Street 1:1515 W FLORIDA AVE
Practice Address - Street 2:SUITE E
Practice Address - City:HEMET
Practice Address - State:CA
Practice Address - Zip Code:92543-3817
Practice Address - Country:US
Practice Address - Phone:951-658-3121
Practice Address - Fax:951-652-6994
Is Sole Proprietor?:No
Enumeration Date:2011-02-16
Last Update Date:2011-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAT9426225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAAT9426OtherLICENSE
CAZZZ17481ZMedicare PIN