MEDICARE: DR. TIMOTHY WILLIAM CUTLER PHARM.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	52173	CA
2	1835G0303X	Geriatric Pharmacist	52173	CA

General Provider Information

NPI Number	:	1740272541
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TIMOTHY WILLIAM CUTLER PHARM.D.

Provider Business Mailing Address
First Line	:	2710 BRANDYWINE PL
Second Line	:
City	:	DAVIS
State	:	CA
Zip	:	95616-2905
Country	:	US
Telephone Number	:	916-703-4006
Fax Number	:

Provider Business Practice Location Address
First Line	:	4860 Y ST
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95817-2307
Country	:	US
Telephone Number	:	916-703-4006
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/17/2005
Last Update Date	:	01/04/2010

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