Healthcare Provider Details

I. General information

NPI: 1659765279
Provider Name (Legal Business Name): TRIMBLE & TIEU CHIROPRACTIC, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/20/2015
Last Update Date: 03/20/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3711 LONG BEACH BLVD SUITE 200
LONG BEACH CA
90807-3315
US

IV. Provider business mailing address

3711 LONG BEACH BLVD SUITE 200
LONG BEACH CA
90807-3315
US

V. Phone/Fax

Practice location:
  • Phone: 562-428-1490
  • Fax: 562-428-1409
Mailing address:
  • Phone: 562-428-1490
  • Fax: 562-428-1409

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC26820
License Number StateCA

VIII. Authorized Official

Name: DR. GUY L TRIMBLE IV
Title or Position: MEDICAL DIRECTOR
Credential: D.C.
Phone: 562-428-1490