Provider Demographics
NPI:1053436550
Name:LESSER, TIMOTHY F (MD)
Entity type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:F
Last Name:LESSER
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 1:20911 EARL ST
Mailing Address - Street 2:SUITE 140
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90503-4352
Mailing Address - Country:US
Mailing Address - Phone:310-542-0199
Mailing Address - Fax:310-542-4652
Practice Address - Street 1:20911 EARL ST
Practice Address - Street 2:SUITE 140
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90503
Practice Address - Country:US
Practice Address - Phone:323-783-4011
Practice Address - Fax:310-542-4652
Is Sole Proprietor?:No
Enumeration Date:2007-03-21
Last Update Date:2023-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA90955208800000X, 208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAP00647441OtherMEDICARE GROUP PTAN
CABZ304ZMedicare PIN