Provider Information for 1003112368
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TIM JAMES CROSBY
Sex: Male
NPI: 1003112368
Last Updated: 2021-05-20
Certification Date: 2021-05-20
Certification Date: 2021-05-20
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1003112368 | ||||||||
| Enumeration Date | 2011-02-03 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 150 S 3RD AVE ARCADIA, CA 91006-3703 United States Phone: 626-821-8370 | Fax: | ||||||||
| Primary Practice Address | 9829 CARMENITA RD STE H WHITTIER, CA 90605-3262 United States Phone: 562-907-7429 | Fax: | ||||||||
| Secondary Practice Address(es) | 150 S 3RD AVE | ||||||||
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