Healthcare Provider Details

I. General information

NPI: 1235143454
Provider Name (Legal Business Name): TIMOTHY PILCHARD MSPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2006
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13808 MONO WAY
SONORA CA
95370-8864
US

IV. Provider business mailing address

21732 WATER OAK DR
SONORA CA
95370-9643
US

V. Phone/Fax

Practice location:
  • Phone: 209-532-2928
  • Fax:
Mailing address:
  • Phone: 209-532-9052
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT-5405
License Number StateID
# 2
Primary TaxonomyN
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License NumberPT 20917
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: