Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NS0005X | Chiropractic Sports Physician | 18565 | CA |
NPI | 1346232824 |
---|---|
Provider Name | Dr. Timothy Roger Noble |
First Address | Anaheim, CA 92807-3233 |
Second Address | Anaheim, CA 92807-3233 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/08/2005 |
Last Update Date | 25/08/2010 |