| Doctor Name: | TIMOTHY JOSEPH SPRAGUE |
| NPI Number: | 1487797122 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | G37181 |
| Business Practice Address: | 15031 Rinaldi St Mission Hills, CA - 913451207 |
| Business Phone Number: | 8188984530 |
| Business Fax Number: | 8188984451 |
| Mailing Address: | 2402 La Mesa Dr, SANTA MONICA |
| State: | CA |
| Postal Code: | 904022343 |
| Phone Number: | 3103938895 |
| Fax Number: | |
| NPI Enumeration Date: | 02/14/2007 |
| NPI Last Update Date: | 06/03/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2085B0100X |
| License Number: | G37181 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | CA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Radiology |
| Taxonomy Specialization: | Body Imaging |
| Taxonomy Definition: | A Radiology doctor of Osteopathy that specializes in Body Imaging. |