TYLER JACOB HENDRICKS M.D.
NPI 1295114171
Family Medicine in San Diego, CA

Q: What is Tyler Hendricks's NPI number?

The NPI number for Tyler Hendricks is 1295114171. It was assigned to this individual provider in the NPPES registry on May 25, 2015.

Q: What is Tyler Hendricks's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Q: When was this NPI record last updated?

The NPPES record for Tyler Hendricks was last updated on November 3, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.

Active since May 25, 2015

6195 LUSK BLVD STE 250, SAN DIEGO, CA 92121(239) 343-2371 Get Directions Write a Review

NPPES record last updated: November 3, 2022. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Nov 3, 2022, Sep 10, 2021, Jun 16, 2021 and 2 more (5 updates tracked since 2019).

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About Tyler Jacob Hendricks M.d. NPPES

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

TYLER JACOB HENDRICKS M.D. (NPI 1295114171) is an individual family medicine provider in San Diego, California, licensed in Florida (ME133173) and active in the NPI registry since May 2015.

NPPES Registry Identity

NPI1295114171

Entity TypeIndividualMale

Primary Taxonomy207Q00000X

Provider Legal NameTYLER JACOB HENDRICKSCredential: M.D.

Location Address6195 LUSK BLVD STE 250San Diego, CA 92121-3715

Mailing Address11940 Laura Rose CtJacksonville, FL 32223-0764 · (904) 504-7618

Phone(239) 343-2371

Sole ProprietorNo

Enumeration DateMay 25, 2015

Last NPPES UpdateNovember 3, 20225 updates tracked since enumeration

NPPES CertifiedNovember 3, 2022

✔ NPI 1295114171 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

Licenses✔ Licensed in FL · ME133173✔ Licensed in MD · D86787✔ Licensed in LA · 311985✔ Licensed in NJ · 25MA10673900✔ Licensed in PA · MD466543✔ Licensed in HI · MD-19793✔ Licensed in UT · 11567414-1205✔ Licensed in ME · MD23563✔ Licensed in OK · 35178✔ Licensed in CO · DR.0062561

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

6195 LUSK BLVD STE 250, San Diego, CA 92121

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Other Providers at the Same Location NPPES 20

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

ALEX BOLTON APRN

Nurse Practitioner (Family)