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Organization
LYONS & POPPLE MEDICAL CORP
Active
Organization
LYONS & POPPLE MEDICAL CORP
Active
Other names
Up Valley Anesthesia Medical Corp
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TIMOTHY LYONS MD (GROUP PRESIDENT)
(707) 963-3611
Entity
Organization
Contact information
Practice address
650 SANITARIUM, DEER PARK, CA 94576
(707) 963-3611
Mailing address
PO BOX 7096, STOCKTON, CA 95267
(209) 956-7725
(209) 956-7733
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0092420
—
CA
01
—
ZZZ03794Z
BS OF CA
CA
Enumeration date
05/15/2006
Last updated
07/02/2008
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