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General NPI Number Information
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NPI Number | 1457361701
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Entity Type | Individual
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Provider Name | TIMOTHY JAMES LIDDY DPM
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Gender | Male
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Dates
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Enumeration Date | 08/09/2006
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Last Update Date | 12/11/2023
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Provider Practice Location Address
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Address Line | 9100 WILSHIRE BLVD. STE. 503-E
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City | BEVERLY HILLS
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State | CA
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Zip | 90212
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Country | US
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Telephone | 310-652-1163
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Fax | 310-652-2713
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Provider Business Mailing Address
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Address Line | 9100 WILSHIRE BLVD. STE. 503-E
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City | BEVERLY HILLS
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State | CA
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Zip | 90212
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Country | US
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Telephone | 310-652-1163
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Fax | 310-652-2713
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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 | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | E3631
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License Number State | CA
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