Individual
TIMOTHY RYAN DONAHUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
200 UCLA MEDICAL PLZ STE 214, LOS ANGELES, CA 90095-0001
(310) 794-7788
(310) 794-4337
Mailing address
5767 W CENTURY BLVD, SUITE 400, LOS ANGELES, CA 90045-5631
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
A86040
CA
2086X0206X
Surgical Oncology Physician
A86040
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A860400
—
CA
Enumeration date
10/21/2008
Last updated
12/23/2019
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