Individual
TIMOTHY PATRICK CLOHERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5652 CALLE REAL, GOLETA, CA 93117-2317
(805) 967-1539
Mailing address
5652 CALLE REAL, GOLETA, CA 93117-2317
(805) 967-1539
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
G843840
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G843840
—
CA
01
—
1356409379
GROUP NPI
CA
01
—
G843840
MEDICAL BOARD OF CA
CA
01
—
ZZZ42967Z
BLUE SHIELD
CA
Enumeration date
12/04/2006
Last updated
03/05/2014
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