Paik-Nicely, Timothy Charles

Paik-Nicely, Timothy Charles is an sole proprietor health care provider with primary practice located at 2505 Lucas St Ste B, Eureka CA 95501-3340. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Emergency Medicine. Allopathic & Osteopathic Physicians / Emergency Medicine is his primary health care specialty. Paik-Nicely, Timothy Charles can be contacted via phone (707) 601-9767.

Contact Information

Primary practice address
2505 Lucas St Ste B Eureka CA 95501-3340
Phone: (707) 601-9767
Fax: (707) 601-9746
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X G44510 California
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X G44510 California

Profile Details

NPI number 1760489389
LBN Legal business name Paik-Nicely, Timothy Charles
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 29th, 2005
Last updated Sep 20th, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1760489389 NPPES
California MEDICAID 00G445100

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