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NPI Code Detail

MEDICARE: DR. TIMOTHY JAMES PERLICK PHARM.D.

MEDICARE: DR. TIMOTHY JAMES PERLICK PHARM.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist048172CA

General Provider Information

NPI Number : 1558444620
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. TIMOTHY JAMES PERLICK PHARM.D.
Provider Business Mailing Address
First Line : 92 VIA SAN MARCO
Second Line :
City : RANCHO MIRAGE
State : CA
Zip : 92270-5621
Country : US
Telephone Number : 760-770-5388
Fax Number :
Provider Business Practice Location Address
First Line : 75036 GERALD FORD DR
Second Line :
City : PALM DESERT
State : CA
Zip : 92211-2080
Country : US
Telephone Number : 760-834-2508
Fax Number : 760-834-2534
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/23/2006
Last Update Date : 07/08/2007

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