Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 33351 | CA |
N | 111NX0100X | Occupational Health | 11935 | TX |
NPI | 1912279647 |
---|---|
Provider Name | Timothy T. Cambridge |
First Address | San Jose, CA 95161-1466 |
Second Address | Pleasanton, CA 94566-7654 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/01/2012 |
Last Update Date | 27/07/2015 |