Provider Demographics
NPI:1710965462
Name:BROWDER, TIMOTHY D (MD)
Entity type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:D
Last Name:BROWDER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 743749
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90074-3749
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1001 POTRERO AVE. BLDG. 5, #3M
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94110
Practice Address - Country:US
Practice Address - Phone:628-206-8814
Practice Address - Fax:415-206-5484
Is Sole Proprietor?:No
Enumeration Date:2006-01-04
Last Update Date:2024-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA96189208600000X, 2086S0102X
NV11045208600000X, 2086S0127X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0102XAllopathic & Osteopathic PhysiciansSurgerySurgical Critical Care
No208600000XAllopathic & Osteopathic PhysiciansSurgery
No2086S0127XAllopathic & Osteopathic PhysiciansSurgeryTrauma Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV5590203OtherFIRST HEALTH/CCN
NV880330858OtherCHOICE CARE/HUMANA
NV9217630OtherMULTIPLAN
NV100505405Medicaid
NV880330858OtherUNITED HEALTHCARE
NV880330858OtherBEECH STREET
NV880330858OtherUNIVERSAL HEALTH NETWORK
NVXPY206416OtherMEDI-CAL
NV880330858OtherHORIZON/MCC
NV880330858OtherAFFILIATED HEALTH FUNDS
NV880330858OtherSIERRA HEALTH SERVICES
NV880330858OtherCIGNA
NV880330858OtherPHCS
NV880330858OtherPACIFICARE
NV880330858OtherANTHEM BC/BS
NV916702OtherAHCCCS
NV964190OtherUSA/MCO HEALTH NETWORK
NV100505405Medicaid
NVWQBHV100231Medicare ID - Type Unspecified