Healthcare Provider Details

I. General information

NPI: 1194722264
Provider Name (Legal Business Name): TIMOTHY JOSEPH HAYES M.D., M.P.H.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 07/05/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1301 20TH ST STE 210
SANTA MONICA CA
90404-2088
US

IV. Provider business mailing address

1301 20TH ST STE 210
SANTA MONICA CA
90404-2088
US

V. Phone/Fax

Practice location:
  • Phone: 310-315-0303
  • Fax: 310-315-0302
Mailing address:
  • Phone: 310-315-0303
  • Fax: 310-315-0302

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberG36996
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code2084P0802X
TaxonomyAddiction Psychiatry Physician
License NumberG36996
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code2084P0805X
TaxonomyGeriatric Psychiatry Physician
License NumberG36996
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: