Provider Demographics
NPI:1720224561
Name:MCCARTHY, TIMOTHY DANIEL (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:DANIEL
Last Name:MCCARTHY
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:416 NORFOLK DR
Mailing Address - Street 2:#5
Mailing Address - City:PACIFICA
Mailing Address - State:CA
Mailing Address - Zip Code:94044-2048
Mailing Address - Country:US
Mailing Address - Phone:916-955-6055
Mailing Address - Fax:
Practice Address - Street 1:1600 LOS GAMOS DR
Practice Address - Street 2:#275
Practice Address - City:SAN RAFAEL
Practice Address - State:CA
Practice Address - Zip Code:94903-1806
Practice Address - Country:US
Practice Address - Phone:415-492-6500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-12-29
Last Update Date:2008-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA403641835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist