Provider Demographics
NPI:1629158761
Name:DOWNING, TIMOTHY H (MD)
Entity Type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:H
Last Name:DOWNING
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3819 GRANDVIEW DR
Mailing Address - Street 2:
Mailing Address - City:BREA
Mailing Address - State:CA
Mailing Address - Zip Code:92823-1066
Mailing Address - Country:US
Mailing Address - Phone:714-854-1702
Mailing Address - Fax:
Practice Address - Street 1:ST. JUDE MEDICAL CENTER
Practice Address - Street 2:101 E. VALENCIA MESA DR.
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92835
Practice Address - Country:US
Practice Address - Phone:714-992-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA000000G79060207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G790600Medicaid
CAWG79060AMedicare ID - Type Unspecified
CA00G790600Medicaid