TIMOTHY A VAN DYNE DPM INC NPI 1962629824

NPI Information

NPI: 1962629824
Provider Name: TIMOTHY A VAN DYNE DPM INC
Classification: Clinic/Center - 261QP1100X
Entity Type: Organization

Specialization: Podiatric

Address:
5777 N FRESNO ST
SUITE 102
FRESNO, CA
ZIP 93710
Phone: (559) 435-0261
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TIMOTHY A VAN DYNE DPM INC is a podiatric clinic center in Fresno, CA. TIMOTHY A VAN DYNE DPM INC NPI is 1962629824. The provider is registered as an organization entity type.

The provider's business location address is:

5777 N FRESNO ST
SUITE 102
FRESNO, CA
ZIP 93710-065
Phone: (559) 435-0261

The provider's authorized official is Timothy Allen Van Dyne .
The authorized official title is President and has the following contact phone number (559) 435-0261.

The enumeration date for this NPI number is 4/19/2007 and was last updated on 2/24/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QP1100X	Clinic/Center	Podiatric	E2025	CALIFORNIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	E2025	OTHER	CALIFORNIA	MEDICARE ID 000E20250

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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