Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Timothy Ryan Edgar, IDC

Individual provider Independent Duty Corpsman · NPI 1184059578

Timothy Ryan Edgar, IDC is an Independent Duty Corpsman in San Diego, California. Practices as a sole proprietor. Licensed in California.

Licensed in
CA
In the registry since
2013
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Practice location Address checks out

3883 Ingraham St Apt #U309
San Diego, CA 92109-6433
Phone: (559) 975-5651
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Independent Duty Corpsman (primary) Taxonomy 1710I1002X · Licence D6476308 (CA)

Record details

NPI number1184059578
Entity typeIndividual (Type 1)
GenderMale
Credentials IDC
Sole proprietorYes
NPI enumeratedSeptember 4, 2013
Last updated in NPPESSeptember 4, 2013

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