Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111NR0200X | Radiology | CA22671 | CA |
N | 213ER0200X | Radiology | CA22671 | CA |
N | 111NR0400X | Rehabilitation Chiropractor | CA22671 | CA |
NPI | 1316003916 |
---|---|
Provider Name | Dr. Tim J Franks |
First Address | Tustin, CA 92780-3424 |
Second Address | Tustin, CA 92780-3424 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/12/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U52794 | (02) | CA |
ZZZ561600Z | BLUE SHIELD (01) | CA |