Provider Demographics
NPI:1780682070
Name:MURPHY, TIMOTHY A (MD)
Entity Type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:A
Last Name:MURPHY
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 1:577 E ELDER ST
Mailing Address - Street 2:STE C
Mailing Address - City:FALLBROOK
Mailing Address - State:CA
Mailing Address - Zip Code:92028-3079
Mailing Address - Country:US
Mailing Address - Phone:760-723-5459
Mailing Address - Fax:760-723-7872
Practice Address - Street 1:577 E ELDER ST
Practice Address - Street 2:STE C
Practice Address - City:FALLBROOK
Practice Address - State:CA
Practice Address - Zip Code:92028-3079
Practice Address - Country:US
Practice Address - Phone:760-723-5459
Practice Address - Fax:760-723-7872
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG459632084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G459630Medicaid
CAG45963Medicare ID - Type Unspecified
CA00G459630Medicaid