Provider Demographics
NPI:1700870243
Name:SPIEGEL, TIMOTHY M (MD)
Entity Type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:M
Last Name:SPIEGEL
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 1:1919 STATE ST
Mailing Address - Street 2:STE 306
Mailing Address - City:SANTA BARBARA,
Mailing Address - State:CA
Mailing Address - Zip Code:93101-8448
Mailing Address - Country:US
Mailing Address - Phone:805-682-5752
Mailing Address - Fax:805-682-8434
Practice Address - Street 1:1919 STATE ST
Practice Address - Street 2:STE 306
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93101-2430
Practice Address - Country:US
Practice Address - Phone:805-682-5752
Practice Address - Fax:805-682-8434
Is Sole Proprietor?:No
Enumeration Date:2005-09-09
Last Update Date:2007-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC37216207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00C372160Medicaid
CA00C372160Medicaid
CAC37216Medicare ID - Type Unspecified