Wiley, Timothy Earl

Wiley, Timothy Earl is an sole proprietor health care provider with primary practice located at 227 N Jackson Ave , San Jose CA 95116-1603. He recently has only one registered license in Eye and Vision Services Providers / Technician/Technologist, which is considered as his primary health care specialty. Wiley, Timothy Earl can be contacted via phone (408) 729-7115.

Contact Information

Primary practice address
227 N Jackson Ave San Jose CA 95116-1603
Fax: (408) 729-7115
Website:

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Technician/Technologist 156F00000X D3539 California

Profile Details

NPI number 1750596755
LBN Legal business name Wiley, Timothy Earl
Credentials RDO
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 11th, 2007
Last updated Jul 9th, 2007 - about 17 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 1750596755 NPPES
California MEDICAID 1713912

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