Organization Active NPI

Timothy R. Dooley, M.D., Professional Corporation

  • General Practice Physician
  • San Diego, CA
National Provider Identifier
1679900419
Registry record updated Jul 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
G69284 Issued in CA
Legal business name
TIMOTHY R. DOOLEY, M.D., PROFESSIONAL CORPORATION
Practice address
2525 Camino del Rio S Ste 130
San Diego, CA 92108-3718
Phone
(619) 297-8641
NPI assigned
Oct 10, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2022

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

Authorized official

Name
Timothy Rupert Dooley, MDNPI 1366557258
Title
Physician
Phone
(619) 297-8641

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208D00000X G69284 CA Primary

Addresses

Primary practice location

2525 Camino del Rio S Ste 130
San Diego, CA 92108-3718

Mailing address

2525 Camino del Rio S Ste 130
San Diego, CA 92108-3718
Phone (619) 297-8641

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140117000153 CA Part B Supplier - Clinic/Group Practice 7911135082 Receives reassigned benefits from 1 practitioner
Practice locations: San Diego, CA

National Provider Directory

National Provider Directory

Locations

2333 Camino del Rio S
Ste 130
San Diego, CA 92108
Phone (619) 297-8641

3446 Park Blvd
San Diego, CA 92103
Phone (619) 295-3470

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1381363200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1657238400000",
    "number": "1679900419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2525 CAMINO DEL RIO S STE 130",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921083718",
            "telephone_number": "619-297-8641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 CAMINO DEL RIO S STE 130",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921083718",
            "telephone_number": "619-297-8641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIMOTHY R. DOOLEY, M.D., PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-10",
        "last_updated": "2022-07-08",
        "certification_date": "2022-07-08",
        "status": "A",
        "authorized_official_last_name": "DOOLEY",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "RUPERT",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "619-297-8641",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": "CA",
            "license": "G69284",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.