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Individual

DR. ALLISON M TIMS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
D.O.

Contact information

Practice address
1755 COURT ST, REDDING, CA 96001-1721
(302) 478-8005
(530) 241-1174
Mailing address
3400 DATA DR, ATTN: CREDENTIALING/PAYER ENROLLMENT, RANCHO CORDOVA, CA 95670-7956

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
20A15887
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
025493
KAISER COMMERCIAL NUMBER
CO
05
74124846
CO
Enumeration date
07/25/2012
Last updated
03/22/2018
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