Timothy George Dutra
Foot and Ankle Orthopaedic Surgeon
13847 E 14th St #110a
San Leandro
, California 94578-2632
Timothy George Dutra
Foot and Ankle Orthopaedic Surgeon
13847 E 14th St #110a
San Leandro
, California 94578-2632
(510) 351-1797
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About
Features
Specialties
- Foot and Ankle Orthopaedic Surgeon
Languages spoken
- English
Location
First Address
- Timothy George Dutra
- 13847 E 14th St #110a
- San Leandro, CA
- Zip : 94578-2632
- Fax : (510) 351-1797
- Phone : (510) 351-7122
Second Address
- Timothy George Dutra
- 13847 E 14th St #110a
- San Leandro, CA
- Zip : 94578-2632
- Fax : (510) 351-1797
- Phone : (510) 351-7122
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | E33830 | CA |
National Provider Identifier
| NPI | 1588650162 |
|---|---|
| Provider Name | Timothy George Dutra |
| First Address | San Leandro, CA 94578-2632 |
| Second Address | San Leandro, CA 94578-2632 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 20/09/2005 |
| Last Update Date | 08/07/2007 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| T11665 | (02) | CA |
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.