Mr. Ty Preston Affleck
Family Doctor - Sports Medicine
1255 N Dutton Ave
Santa Rosa
, California 95401-4663
Mr. Ty Preston Affleck
Family Doctor - Sports Medicine
1255 N Dutton Ave
Santa Rosa
, California 95401-4663
(707) 546-9464
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About
Features
Specialties
- Family Doctor - Sports Medicine
Languages spoken
- English
Location
First Address
- Mr. Ty Preston Affleck
- 1255 N Dutton Ave
- Santa Rosa, CA
- Zip : 95401-4663
- Fax : (707) 546-9464
- Phone : (707) 546-9400
Second Address
- Mr. Ty Preston Affleck
- 1255 N Dutton Ave
- Santa Rosa, CA
- Zip : 95401-4663
- Fax : (707) 546-9464
- Phone : (707) 546-9400
Reviews
FAQs
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Is Mr. Ty Preston Affleck a sole practitioner?
Is Mr. Ty Preston Affleck accepting new patients?
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207QS0010X | Family Doctor - Sports Medicine | G073843 | CA |
National Provider Identifier
| NPI | 1306941083 |
|---|---|
| Provider Name | Mr. Ty Preston Affleck |
| First Address | Santa Rosa, CA 95401-4663 |
| Second Address | Santa Rosa, CA 95401-4663 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 14/09/2006 |
| Last Update Date | 11/05/2009 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| E71942 | (02) |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.