Healthcare Provider Details

I. General information

NPI: 1093342842
Provider Name (Legal Business Name): TIMOTHY SANTOS CUYEGKENG DO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/23/2020
Last Update Date: 09/18/2025
Certification Date: 09/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2800 L ST STE 500
SACRAMENTO CA
95816-5616
US

IV. Provider business mailing address

PO BOX 255228
SACRAMENTO CA
95865-5228
US

V. Phone/Fax

Practice location:
  • Phone: 916-454-6850
  • Fax: 916-454-6852
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License Number20A19659
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number20A19659
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: