TIMOTHY A VAN DYNE DPM INC NPI 1962629824

NPI Information

  • NPI: 1962629824
  • Provider Name: TIMOTHY A VAN DYNE DPM INC
  • Classification: Clinic/Center - 261QP1100X
  • Specialization: Podiatric
  • Entity Type: Organization
  • Address: 5777 N FRESNO ST
    SUITE 102
    FRESNO, CA
    ZIP 93710
  • Phone: (559) 435-0261

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NPI Details

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
1261QP1100XClinic/CenterPodiatricE2025CALIFORNIAYes

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
1E2025OTHERCALIFORNIAMEDICARE 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: 11/21/2025

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