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
Phone: (408) 729-7115
Fax: (408) 729-7115
Website:
Health care specialties
| Specialty | Code | License # | 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 18 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1750596755 | NPPES |
| California | MEDICAID | 1713912 |
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