Individual
TIMOTHY D HOOPER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
13951 MONO WAY, STE A, SONORA, CA 95370-4856
(209) 532-3370
(209) 532-3340
Mailing address
18701 TIFFENI DR, SUITE 1A, TWAIN HARTE, CA 95383-9406
(209) 586-1400
(209) 586-6748
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
G55188
CA
207QA0401X
Addiction Medicine (Family Medicine) Physician
G55188
CA
208D00000X
General Practice Physician
Primary
G55188
CA
208VP0000X
Pain Medicine Physician
G55188
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZZZ20686Z
—
CA
Enumeration date
07/19/2006
Last updated
04/06/2011
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