Basic Information
| Provider Information | |||||||||
| NPI: | 1215946355 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DOWLING | ||||||||
| FirstName: | TIMOTHY | ||||||||
| MiddleName: | F | ||||||||
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| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1310 CLUB DR STE 109 | ||||||||
| Address2: | |||||||||
| City: | VALLEJO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 945921189 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 1222 PINE ST STE A | ||||||||
| Address2: | |||||||||
| City: | SAINT HELENA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 945741830 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7079630931 | ||||||||
| FaxNumber: | 7072541779 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/07/2006 | ||||||||
| LastUpdateDate: | 06/21/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/21/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | C20004476 | DE | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | 18094 | CA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 0000745903 | 01 | DELAWARE PHYSICIANS CARE | OTHER | 510064326 | 01 | AETNA HEALTHCARE | OTHER | 0000745903 | 05 | DE | MEDICAID | 6124015 | 01 | BCBS OF DE | OTHER | 0880974000 | 01 | AMERIHEALTH | OTHER | 863637 | 01 | ALLIANCE | OTHER | 27825 | 01 | CAVENTRY | OTHER |