Provider Demographics
NPI:1215946355
Name:DOWLING, TIMOTHY F (DO)
Entity type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:F
Last Name:DOWLING
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1310 CLUB DR STE 109
Mailing Address - Street 2:
Mailing Address - City:VALLEJO
Mailing Address - State:CA
Mailing Address - Zip Code:94592-1189
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1222 PINE ST STE A
Practice Address - Street 2:
Practice Address - City:SAINT HELENA
Practice Address - State:CA
Practice Address - Zip Code:94574-1830
Practice Address - Country:US
Practice Address - Phone:707-963-0931
Practice Address - Fax:707-254-1779
Is Sole Proprietor?:No
Enumeration Date:2006-08-07
Last Update Date:2022-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC20004476207Q00000X
CA18094207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
0000745903OtherDELAWARE PHYSICIANS CARE
510064326OtherAETNA HEALTHCARE
DE0000745903Medicaid
6124015OtherBCBS OF DE
0880974000OtherAMERIHEALTH
863637OtherALLIANCE
27825OtherCAVENTRY
27825OtherCAVENTRY
0880974000OtherAMERIHEALTH