Provider Demographics
NPI:1609199751
Name:TIMOTHY F. ISAACS M.D. APC
Entity Type:Organization
Organization Name:TIMOTHY F. ISAACS M.D. APC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:FREDERICK
Authorized Official - Last Name:ISAACS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:650-992-2223
Mailing Address - Street 1:901 CAMPUS DR STE 301
Mailing Address - Street 2:
Mailing Address - City:DALY CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94015-4930
Mailing Address - Country:US
Mailing Address - Phone:650-992-2223
Mailing Address - Fax:650-992-2220
Practice Address - Street 1:901 CAMPUS DR STE 301
Practice Address - Street 2:
Practice Address - City:DALY CITY
Practice Address - State:CA
Practice Address - Zip Code:94015-4930
Practice Address - Country:US
Practice Address - Phone:650-992-2223
Practice Address - Fax:650-992-2220
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-03
Last Update Date:2010-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG1919502084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA8402917Medicaid
CA8402917Medicaid