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General NPI Number Information
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NPI Number | 1629361027
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Entity Type | Individual
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Provider Name | TIMOTHY LI DO
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Gender | Male
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Dates
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Enumeration Date | 05/18/2011
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Last Update Date | 07/14/2025
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Provider Practice Location Address
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Address Line | 23811 WASHINGTON AVE # C110-220
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City | MURRIETA
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State | CA
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Zip | 92562-2275
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Country | US
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Telephone | 951-231-1385
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Fax | 866-686-7693
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Provider Business Mailing Address
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Address Line | 11555 1/2 POTRERO RD RIVERSIDE-SAN BERNARDINO COUNTY INDIAN HEALTH, INC.
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City | BANNING
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State | CA
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Zip | 92220-6946
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Country | US
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Telephone |
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 20A 12572
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License Number State | CA
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