| Doctor Name: | TIM RICHARD DOREN |
| NPI Number: | 1528395365 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PA-C |
| License Number: | 20287 |
| Business Practice Address: | 1901 Town And Country Dr Norco, CA - 928603611 |
| Business Phone Number: | 9517378141 |
| Business Fax Number: | |
| Mailing Address: | Po Box 77744, CORONA |
| State: | CA |
| Postal Code: | 928770124 |
| Phone Number: | 9515490646 |
| Fax Number: | |
| NPI Enumeration Date: | 11/16/2009 |
| NPI Last Update Date: | 11/16/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | 20287 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |