MEDICARE: TIMOTHY MICHAEL WIMMER M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207X00000X	Orthopaedic Surgery Physician	IN 01055470	IN
2	207X00000X	Orthopaedic Surgery Physician	C54546	CA

General Provider Information

NPI Number	:	1811955735
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TIMOTHY MICHAEL WIMMER M.D.

Provider Business Mailing Address
First Line	:	1543 9TH AVE
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92101-2877
Country	:	US
Telephone Number	:	619-230-1510
Fax Number	:

Provider Business Practice Location Address
First Line	:	2826 HARRIS ST
Second Line	:
City	:	EUREKA
State	:	CA
Zip	:	95503-4809
Country	:	US
Telephone Number	:	707-443-8066
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/02/2006
Last Update Date	:	09/17/2024

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