Healthcare Provider Details

I. General information

NPI: 1093017519
Provider Name (Legal Business Name): TIMOTHY E MYERS PHARM.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/03/2010
Last Update Date: 12/03/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

235 TENNANT STA
MORGAN HILL CA
95037-5463
US

IV. Provider business mailing address

2045 TERRA CALIFORNIA WAY
MORGAN HILL CA
95037-7026
US

V. Phone/Fax

Practice location:
  • Phone: 408-782-5185
  • Fax: 408-779-6730
Mailing address:
  • Phone: 408-782-5185
  • Fax: 408-779-6730

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number46549
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: