Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 151538 | CA |
Y | 208600000X | Surgeon | 151538 | CA |
NPI | 1003261892 |
---|---|
Provider Name | Timothy Guenther |
First Address | Sacramento, CA 95820-1517 |
Second Address | Sacramento, CA 95817-2201 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/04/2016 |
Last Update Date | 14/09/2017 |