Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
TIM SULLIVAN, MD
Deactivated Sole ProprietorTIM SULLIVAN, MD is a Pediatrics healthcare provider located in SONORA, California. NPI 1750481099 is deactivated in the NPPES registry. Verify at CMS.
Pediatrics · SONORA, CA
This NPI has been deactivated.
The record was deactivated on July 12, 2019.
Deactivated NPIs are no longer valid for billing or credentialing. The provider may have retired, changed practice status, or had their NPI administratively deactivated.
Verify current licensure status with the NPPES NPI Registry or the relevant state medical board before relying on this record.
Registration Details
- NPI Number
- 1750481099
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Sep 25, 2006 (12.794520547945 yrs)
- Last Updated
- Jul 29, 2019
- Deactivated
- Jul 12, 2019
- Licenses
-
34411 (IA)C55917 (CA)
- Sole Proprietor
- Yes
Practice Information
- Address
-
12791 CABEZUT RDSONORA, CA, 953705926Browse CA providers · Browse ZIP 95370
- Phone
- 2095325524
- Fax
- 2095321513
- Primary Specialty
-
Pediatrics
208000000X
- Additional Specialty
- Pediatrics
Other Pediatrics Providers in SONORA, CA
| Name | Credential | NPI |
|---|---|---|
| DR. JENNIFER LYNN NEUFELD-TRUJILLO | MD | 1861482671 |
| WILLIAM DONOVAN SPANGLER | M.D. | 1194701441 |
| DR. KELLEY WILLIAM GEORGE | MD | 1396721171 |
| DR. WILLIAM H. BIRTWHISTLE | M.D. | 1073575312 |
| ANDREW JAMES TERRANELLA | MD, MPH | 1467668145 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.