Healthcare Provider Details

I. General information

NPI: 1578663258
Provider Name (Legal Business Name): TIMOTHY EDWARD INFUHR DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/23/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2820 CAMINO DOS RIOS SUITE 302
NEWBURY PARK CA
91320-1136
US

IV. Provider business mailing address

2820 CAMINO DOS RIOS SUITE 302
NEWBURY PARK CA
91320-1136
US

V. Phone/Fax

Practice location:
  • Phone: 805-375-6380
  • Fax: 805-375-6382
Mailing address:
  • Phone: 805-375-6380
  • Fax: 805-375-6382

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC22718
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: