Davis, Timothy A

Davis, Timothy A is an individual health care provider with primary practice located at 1409 E Briggsmore Ave , Modesto CA 95355-2707. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Surgery, Allopathic & Osteopathic Physicians / Vascular Surgery. Allopathic & Osteopathic Physicians / Surgery is his primary health care specialty. Davis, Timothy A can be contacted via phone (209) 550-4788.

Contact Information

Primary practice address
1409 E Briggsmore Ave Modesto CA 95355-2707
Phone: (209) 550-4788
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X G70793 California
Allopathic & Osteopathic Physicians / Vascular Surgery 2086S0129X G70793 California

Profile Details

NPI number 1114976594
LBN Legal business name Davis, Timothy A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 10th, 2006
Last updated Jun 7th, 2010 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1114976594 NPPES
California MEDICAID 00G707930

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