Individual
TIMOTHY ALBERT BANGAYAN LUI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1625 STOCKTON BLVD STE 207, SACRAMENTO, CA 95816-7092
(510) 683-9500
(877) 880-2039
Mailing address
PO BOX 255228, SACRAMENTO, CA 95865-5228
(800) 470-0071
(916) 854-6769
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA56078
CA
363AS0400X
Surgical Physician Assistant
Primary
PA56078
CA
Other
Enumeration date
10/01/2018
Last updated
02/23/2026
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