Healthcare Provider Details

I. General information

NPI: 1275638165
Provider Name (Legal Business Name): TIMOTHY EVAN LINDAMOOD MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2006
Last Update Date: 01/23/2026
Certification Date: 01/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 CEDAR RD # 102
VISTA CA
92083-5102
US

IV. Provider business mailing address

10790 RANCHO BERNARDO RD
SAN DIEGO CA
92127-5705
US

V. Phone/Fax

Practice location:
  • Phone: 760-806-5431
  • Fax: 760-806-5428
Mailing address:
  • Phone: 760-806-5431
  • Fax: 760-806-5428

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberG64180
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberG64180
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: