Healthcare Provider Details

I. General information

NPI: 1639599830
Provider Name (Legal Business Name): TIMOTHY W MARKLE D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/27/2014
Last Update Date: 04/27/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

960 E GREEN ST SUITE 206
PASADENA CA
91106-2412
US

IV. Provider business mailing address

960 E GREEN ST SUITE 206
PASADENA CA
91106-2412
US

V. Phone/Fax

Practice location:
  • Phone: 626-449-8469
  • Fax: 626-449-7910
Mailing address:
  • Phone: 626-449-8469
  • Fax: 626-449-7910

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NI0013X
TaxonomyIndependent Medical Examiner Chiropractor
License NumberDC16610
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: