Gieseke, Timothy Louis

Gieseke, Timothy Louis is an individual health care provider with primary practice located at 3536 Mendocino Ave 300, Santa Rosa CA 95403-3634. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Gieseke, Timothy Louis can be contacted via phone (707) 546-2180.

Contact Information

Primary practice address
3536 Mendocino Ave 300 Santa Rosa CA 95403-3634
Phone: (707) 546-2180
Fax: (707) 546-2188
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X G34398 California

Profile Details

NPI number 1992703706
LBN Legal business name Gieseke, Timothy Louis
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 14th, 2005
Last updated Feb 7th, 2012 - about 12 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 1992703706 NPPES
California MEDICAID 00G343980
California Other P00602516
California Other 00G343980

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