Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0400X | Rehabilitation Chiropractor | 34479 | CA |
NPI | 1316407380 |
---|---|
Provider Name | Regina Faith Timbang |
First Address | Anaheim, CA 92801-3206 |
Second Address | Tustin, CA 92780-6444 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/03/2019 |
Last Update Date | 24/03/2019 |