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General NPI Number Information
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NPI Number | 1083484539
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Entity Type | Individual
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Provider Name | TIMOTHY ALLEN WARNER
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Gender | Male
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Dates
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Enumeration Date | 01/05/2024
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Last Update Date | 11/12/2024
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Provider Practice Location Address
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Address Line | 5757 WILSHIRE BLVD STE 460
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City | LOS ANGELES
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State | CA
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Zip | 90036-3658
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Country | US
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Telephone | 323-634-0221
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Fax | 323-634-0227
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Provider Business Mailing Address
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Address Line | 35795 WOLF PEN RD
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City | POMEROY
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State | OH
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Zip | 45769-9663
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Country | US
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Telephone | 213-905-8648
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT306099
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License Number State | CA
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