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General NPI Number Information
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NPI Number | 1932264801
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Entity Type | Organization
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Legal Business Name | TIM GURTCH MD, INC.
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Dates
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Enumeration Date | 12/22/2006
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Last Update Date | 03/26/2013
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Provider Practice Location Address
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Address Line | 4276 54-TH PLACE SUITE A
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City | SAN DIEGO
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State | CA
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Zip | 92115
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Country | US
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Telephone | 619-265-1070
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Fax | 619-265-5414
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Provider Business Mailing Address
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Address Line | 4276 54TH PL SUITE A
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City | SAN DIEGO
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State | CA
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Zip | 92115-6011
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Country | US
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Telephone | 619-265-1070
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Fax | 619-265-1454
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. TIM PLATON GURTCH
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Credential | MD
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Telephone | 619-425-5228
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | C50806
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License Number State | CA
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