Provider Demographics
NPI:1639319189
Name:J. TIMOTHY MURPHY, MD
Entity Type:Organization
Organization Name:J. TIMOTHY MURPHY, MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SHEILA
Authorized Official - Middle Name:
Authorized Official - Last Name:PERRYMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:415-897-5171
Mailing Address - Street 1:165 ROWLAND WAY
Mailing Address - Street 2:SUITE 215
Mailing Address - City:NOVATO
Mailing Address - State:CA
Mailing Address - Zip Code:94945-5038
Mailing Address - Country:US
Mailing Address - Phone:415-897-5171
Mailing Address - Fax:415-892-1611
Practice Address - Street 1:165 ROWLAND WAY
Practice Address - Street 2:SUITE 215
Practice Address - City:NOVATO
Practice Address - State:CA
Practice Address - Zip Code:94945-5038
Practice Address - Country:US
Practice Address - Phone:415-897-5171
Practice Address - Fax:415-892-1611
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-24
Last Update Date:2009-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG036133207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA89613Medicare UPIN