Provider Demographics
NPI:1972777316
Name:LEIER, TIM ULRICH (MD)
Entity type:Individual
Prefix:DR
First Name:TIM
Middle Name:ULRICH
Last Name:LEIER
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 1:2700 NEILSON WAY APT 1124
Mailing Address - Street 2:
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90405-4018
Mailing Address - Country:US
Mailing Address - Phone:718-344-2822
Mailing Address - Fax:
Practice Address - Street 1:36101 BOB HOPE DR STE A1
Practice Address - Street 2:
Practice Address - City:RANCHO MIRAGE
Practice Address - State:CA
Practice Address - Zip Code:92270-2002
Practice Address - Country:US
Practice Address - Phone:760-321-1315
Practice Address - Fax:760-321-1094
Is Sole Proprietor?:No
Enumeration Date:2008-04-16
Last Update Date:2024-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC144900208VP0014X, 207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine