Individual
DR. TIMOTHY JOHN DASKIVICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
CHS 66 124, 10833 LECONTE AVE, LOS ANGELES, CA 90095-0001
(310) 206-6766
Mailing address
CHS 66 124, 10833 LECONTE AVE, LOS ANGELES, CA 90095-0001
(310) 206-6766
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
A103871
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1225278211
—
CA
Enumeration date
03/03/2009
Last updated
11/06/2012
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