Provider Demographics
NPI:1689772360
Name:CARLTON, TIMOTHY A (MD)
Entity Type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:A
Last Name:CARLTON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:1399 YGNACIO VALLEY RD
Mailing Address - Street 2:SUITE 11
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94598-2884
Mailing Address - Country:US
Mailing Address - Phone:925-937-1770
Mailing Address - Fax:925-937-0630
Practice Address - Street 1:1399 YGNACIO VALLEY RD
Practice Address - Street 2:SUITE 11
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94598-2884
Practice Address - Country:US
Practice Address - Phone:925-937-1770
Practice Address - Fax:925-937-0630
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2012-06-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG035050207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA4811318Medicaid
CABA773XMedicare PIN
A461967Medicare UPIN
CA4811318Medicaid