Basic Information
| Provider Information | |||||||||
| NPI: | 1538553649 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | JUDSON | ||||||||
| FirstName: | TIMOTHY | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 521 PARNASSUS AVE # 131 | ||||||||
| Address2: | |||||||||
| City: | SAN FRANCISCO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 941432206 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4155148755 | ||||||||
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| Practice Location | |||||||||
| Address1: | 505 PARNASSUS AVE RM 987 | ||||||||
| Address2: | |||||||||
| City: | SAN FRANCISCO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 941430119 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4154761528 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/26/2015 | ||||||||
| LastUpdateDate: | 10/14/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/14/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | 168026171 | CT | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 208M00000X | A48411 | CA | Y | Allopathic & Osteopathic Physicians | Hospitalist |
No ID Information.