Healthcare Provider Details

I. General information

NPI: 1790272599
Provider Name (Legal Business Name): TIMOTHY RICHARD PARENTEAU MD, PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/17/2018
Last Update Date: 08/08/2025
Certification Date: 08/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3300 WEBSTER ST STE 1106
OAKLAND CA
94609-3125
US

IV. Provider business mailing address

3300 WEBSTER ST STE 1106
OAKLAND CA
94609-3125
US

V. Phone/Fax

Practice location:
  • Phone: 510-817-2000
  • Fax:
Mailing address:
  • Phone: 510-817-2000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License NumberA167098
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: