Healthcare Provider Details

I. General information

NPI: 1144981663
Provider Name (Legal Business Name): TIMOTHY MCLAUGHLIN HHP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/06/2022
Last Update Date: 01/06/2022
Certification Date: 01/06/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1137 MIRA LUNA
PALM SPRINGS CA
92262-1245
US

IV. Provider business mailing address

1137 MIRA LUNA
PALM SPRINGS CA
92262-1245
US

V. Phone/Fax

Practice location:
  • Phone: 619-512-3445
  • Fax:
Mailing address:
  • Phone: 619-512-3445
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number87360
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: