Healthcare Provider Details

I. General information

NPI: 1841386240
Provider Name (Legal Business Name): JOSHUA TIMOCK M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: JOSH MCCARTHY TIMOCK

II. Dates (important events)

Enumeration Date: 10/04/2006
Last Update Date: 04/16/2026
Certification Date: 04/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

925 CORPORATE CNTR PKWY
SANTA ROSA CA
95407-5451
US

IV. Provider business mailing address

932 SILVER RAIN RD
LAWRENCE KS
66049-5044
US

V. Phone/Fax

Practice location:
  • Phone: 707-303-3600
  • Fax:
Mailing address:
  • Phone: 970-646-3583
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number208736
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: