Organization
TIMOTHY RUPP MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JANA SPEDALIERE NP-C (LEAD NURSE PRACTITIONER)
(760) 534-8193
Entity
Organization
Contact information
Practice address
1267 WILLIS ST STE 200, REDDING, CA 96001-0400
(760) 534-8193
Mailing address
1267 WILLIS ST STE 200, REDDING, CA 96001-0400
(760) 534-8193
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
123456789
NEW PRACTICE
CA
Enumeration date
02/28/2023
Last updated
02/28/2023
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