Provider Demographics
NPI:1093977191
Name:TIMOTHY BECHTEL, MD INC.
Entity Type:Organization
Organization Name:TIMOTHY BECHTEL, MD INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:BECHTEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:209-851-2144
Mailing Address - Street 1:2800 N CALIFORNIA ST.
Mailing Address - Street 2:STE 6
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95204-3739
Mailing Address - Country:US
Mailing Address - Phone:209-851-2144
Mailing Address - Fax:209-851-2123
Practice Address - Street 1:2800 N CALIFORNIA ST.
Practice Address - Street 2:STE 6
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95204-3739
Practice Address - Country:US
Practice Address - Phone:209-851-2144
Practice Address - Fax:209-851-2123
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-30
Last Update Date:2018-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ02392ZMedicare PIN