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Individual

DR. TIMOTHY SILLECK BAILEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
625 CITRACADO PKWY STE 108, ESCONDIDO, CA 92025-6428
(760) 743-1431
(760) 743-6455
Mailing address
625 W CITRACADO PKWY STE 108, STE 108, ESCONDIDO, CA 92025-6428
(760) 743-1431
(760) 743-6455

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
G60763
CA
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
G60763
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00G60763
CA
01
AS316X
DR. BAILEY'S PTAN
01
W3171
PTAN FOR MEDICARE SOUTH
01
ZZZ37242Z
PTAN FOR MEDICARE NORTH
Enumeration date
10/26/2006
Last updated
04/16/2021
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