Healthcare Provider Details

I. General information

NPI: 1447637814
Provider Name (Legal Business Name): TIMOTHY SAMUEL OPYD MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/05/2015
Last Update Date: 05/05/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7601 HOSPITAL DR SUITE 103
SACRAMENTO CA
95823-5408
US

IV. Provider business mailing address

7601 HOSPITAL DR SUITE 103
SACRAMENTO CA
95823-5408
US

V. Phone/Fax

Practice location:
  • Phone: 916-681-1600
  • Fax:
Mailing address:
  • Phone: 916-681-1600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA136022
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: