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MR. TIMOTHY R DONNELLY P.A.
NPI 1083995609
Physician Assistant - Medical in San Diego, CA

Active since September 09, 2011
1501 5TH AVE, SUITE 100, SAN DIEGO, CA 92101(619) 461-3717(619) 461-5663 Get Directions Write a Review

NPPES record last updated: September 27, 2018. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Mr. Timothy R Donnelly P.a. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. TIMOTHY R DONNELLY P.A. (NPI 1083995609) is an individual medical provider in San Diego, California, licensed in California (PA12169) and active in the NPI registry since September 2011.

NPPES Registry Identity

NPI1083995609
Entity TypeIndividualMale
Primary Taxonomy363AM0700X
Provider Legal NameMR. TIMOTHY R DONNELLYCredential: P.A.
Location Address1501 5TH AVE, SUITE 100San Diego, CA 92101-3291
Mailing Address12285 Scripps Poway PkwyPoway, CA 92064-6149 · (951) 708-6508
Phone(619) 461-3717
Fax(619) 461-5663
Sole ProprietorNo
Enumeration DateSeptember 9, 2011
Last NPPES UpdateSeptember 27, 2018
✔ NPI 1083995609 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AM0700X
License✔ Licensed in CA · PA12169
1501 5TH AVE, San Diego, CA 92101
Open in Google Maps ↗

Other Identifiers 1

OtherPA12169CA · California License

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. JESSICA LEIGH THIVIERGE PSY.D.
Psychologist (Addiction (Substance Use Disorder))
1501 5TH AVE
SAN DIEGO, CA 92101
San Diego County (619) 306-3225

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Timothy Donnelly's NPI number?

The NPI number for Timothy Donnelly is 1083995609. It was assigned to this individual provider in the NPPES registry on September 9, 2011.

Where is Timothy Donnelly located?

Timothy Donnelly practices at 1501 5th Ave Suite 100, San Diego, CA 92101. The listed phone number is (619) 461-3717.

What is Timothy Donnelly's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

When was this NPI record last updated?

The NPPES record for Timothy Donnelly was last updated on September 27, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.