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Individual
DR. TIMOTHY EDWIN PHELAN
Active
Individual
DR. TIMOTHY EDWIN PHELAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
G084901
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G849011
MEDICAL PROVIDER NUMBER
CA
01
—
G084901
CA LICENSE NUMBER
CA
Enumeration date
12/13/2006
Last updated
02/09/2024
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