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General NPI Number Information
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NPI Number | 1104897362
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Entity Type | Organization
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Legal Business Name | TIMOTHY J SLOAN MD, A PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 01/27/2006
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Last Update Date | 08/04/2008
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Provider Practice Location Address
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Address Line | 1800 N CALIFORNIA ST
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City | STOCKTON
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State | CA
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Zip | 95204
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Country | US
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Telephone | 209-943-2000
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 986
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City | WOODBRIDGE
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State | CA
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Zip | 95258-0986
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Country | US
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Telephone | 209-339-9036
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Fax | 209-339-1901
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Authorized Official
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Title or Position | MD
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Name | MR. TIMOTHY J SLOAN
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Credential | MD
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Telephone | 209-339-9036
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208G00000X
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Taxonomy Name | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
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License Number | G35657
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License Number State | CA
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