Provider Demographics
NPI:1164761995
Name:SAWYER, TIMOTHY DOUGLAS (BSPT)
Entity Type:Individual
Prefix:MR
First Name:TIMOTHY
Middle Name:DOUGLAS
Last Name:SAWYER
Suffix:
Gender:M
Credentials:BSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:430 MONTEREY AVE STE 5B
Mailing Address - Street 2:
Mailing Address - City:LOS GATOS
Mailing Address - State:CA
Mailing Address - Zip Code:95030-5323
Mailing Address - Country:US
Mailing Address - Phone:408-237-7365
Mailing Address - Fax:707-874-2335
Practice Address - Street 1:430 MONTEREY AVE STE 5B
Practice Address - Street 2:
Practice Address - City:LOS GATOS
Practice Address - State:CA
Practice Address - Zip Code:95030-5323
Practice Address - Country:US
Practice Address - Phone:408-237-7365
Practice Address - Fax:707-874-2335
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-14
Last Update Date:2013-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12832225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist