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General NPI Number Information
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NPI Number | 1518148873
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Entity Type | Individual
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Provider Name | TIMOTHY WAYNE PACE PA
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Gender | Male
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Dates
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Enumeration Date | 11/15/2007
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Last Update Date | 12/11/2024
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Provider Practice Location Address
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Address Line | 7702 MEANY AVE STE 101
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City | BAKERSFIELD
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State | CA
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Zip | 93308-5199
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Country | US
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Telephone | 661-843-7830
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Fax | 661-843-7831
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Provider Business Mailing Address
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Address Line | 7901 4TH ST N STE 300
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City | ST PETERSBURG
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State | FL
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Zip | 33702-4399
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Country | US
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Telephone | 850-572-0296
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 1939
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License Number State | NE
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA9104343
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | PA644
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License Number State | AL
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Taxonomy #4
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | PA9104343
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License Number State | FL
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Taxonomy #5
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | PA1385
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License Number State | ME
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Taxonomy #6
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA23139
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License Number State | CA
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