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General NPI Number Information
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NPI Number | 1659428704
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Entity Type | Individual
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Provider Name | TIMOTHY MITCHELL WIEBE MD, FAANS
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Gender | Male
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Dates
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Enumeration Date | 01/04/2007
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Last Update Date | 03/08/2018
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Provider Practice Location Address
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Address Line | 3545 SAN DIMAS ST
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City | BAKERSFIELD
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State | CA
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Zip | 93301-1605
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Country | US
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Telephone | 661-323-1947
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Fax | 661-323-1904
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Provider Business Mailing Address
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Address Line | PO BOX 9663
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City | BAKERSFIELD
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State | CA
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Zip | 93389-9663
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Country | US
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Telephone | 661-861-0011
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Fax | 661-861-1011
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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 | 207T00000X
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Taxonomy Name | Neurological Surgery Physician
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License Number | A53943
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License Number State | CA
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