Provider Demographics
NPI:1851544712
Name:SAYLES, TIMOTHY LUKE (PA-C)
Entity type:Individual
Prefix:MR
First Name:TIMOTHY
Middle Name:LUKE
Last Name:SAYLES
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:12677 ALCOSTA BLVD STE 175
Mailing Address - Street 2:
Mailing Address - City:SAN RAMON
Mailing Address - State:CA
Mailing Address - Zip Code:94583-4423
Mailing Address - Country:US
Mailing Address - Phone:925-856-5668
Mailing Address - Fax:925-856-4020
Practice Address - Street 1:12677 ALCOSTA BLVD STE 175
Practice Address - Street 2:
Practice Address - City:SAN RAMON
Practice Address - State:CA
Practice Address - Zip Code:94583-4423
Practice Address - Country:US
Practice Address - Phone:925-856-5668
Practice Address - Fax:925-856-4020
Is Sole Proprietor?:No
Enumeration Date:2008-10-23
Last Update Date:2025-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA05968363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX200111701Medicaid
TX200111701Medicaid