Individual provider Active NPI

Tillman E. Dodd Jr., M.D.

  • Emergency Medicine Physician
  • San Luis Obispo, CA
National Provider Identifier
1497738140
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
C38988 Issued in CA
Practice address
283 Madonna Rd
Suite B
San Luis Obispo, CA 93405-5432
Phone
(805) 549-8880
Fax
(805) 783-2009
NPI assigned
Nov 28, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X C38988 CA Primary

Addresses

Primary practice location

283 Madonna Rd
Suite B
San Luis Obispo, CA 93405-5432

Mailing address

283 Madonna Rd
Suite B
San Luis Obispo, CA 93405-5432
Phone (805) 549-8880

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
C38988CAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatric Inpatient Specialists PC Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1133136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1497738140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "283 MADONNA RD",
            "address_2": "SUITE B",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934055432",
            "telephone_number": "805-549-8880",
            "fax_number": "805-783-2009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "283 MADONNA RD",
            "address_2": "SUITE B",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934055432",
            "telephone_number": "805-549-8880",
            "fax_number": "805-783-2009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DODD",
        "first_name": "TILLMAN",
        "middle_name": "E.",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-28",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "C38988",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Luis Obispo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.