Healthcare Provider Details

I. General information

NPI: 1851409429
Provider Name (Legal Business Name): TIMOTHY MORGAN PATCHIN NP, PA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/25/2006
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1150 FREMONT BLVD
SEASIDE CA
93955-5715
US

IV. Provider business mailing address

1615 BUNKER HILL WAY SUITE 100
SALINAS CA
93906-6013
US

V. Phone/Fax

Practice location:
  • Phone: 831-899-8100
  • Fax: 831-899-8105
Mailing address:
  • Phone: 831-796-1304
  • Fax: 831-757-0291

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number9178
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: