Provider Demographics
NPI:1437952330
Name:TIMOTHY H. RAYNER, M.D., A MEDICAL CORPORATION
Entity type:Organization
Organization Name:TIMOTHY H. RAYNER, M.D., A MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:H
Authorized Official - Last Name:RAYNER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:619-255-1646
Mailing Address - Street 1:1350 COLUMBIA ST UNIT 800
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92101-3456
Mailing Address - Country:US
Mailing Address - Phone:619-255-1646
Mailing Address - Fax:619-255-1646
Practice Address - Street 1:1350 COLUMBIA ST UNIT 800
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92101-3456
Practice Address - Country:US
Practice Address - Phone:619-255-1646
Practice Address - Fax:619-255-1646
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-28
Last Update Date:2025-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)