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General NPI Number Information
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NPI Number | 1801424734
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Entity Type | Individual
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Provider Name | TIMOTHY LEE DO
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Gender | Male
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Dates
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Enumeration Date | 03/27/2020
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Last Update Date | 08/29/2025
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Provider Practice Location Address
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Address Line | 4500 BROCKTON AVE STE 105
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City | RIVERSIDE
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State | CA
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Zip | 92501-4006
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Country | US
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Telephone | 951-784-4088
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Fax |
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Provider Business Mailing Address
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Address Line | 18838 ALDRIDGE PL
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City | ROWLAND HEIGHTS
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State | CA
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Zip | 91748-4890
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Country | US
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Telephone | 818-489-2778
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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 | 2081P2900X
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Taxonomy Name | Pain Medicine (Physical Medicine & Rehabilitation) Physician
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License Number | 20A23559
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License Number State | CA
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