MEDICARE: DR. GUY L TRIMBLE IV DC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	DC26820	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	970354	OTHER	CA	QME

General Provider Information

NPI Number	:	1366467334
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GUY L TRIMBLE IV DC

Provider Business Mailing Address
First Line	:	3711 LONG BEACH BLVD
Second Line	:	STE. 200
City	:	LONG BEACH
State	:	CA
Zip	:	90807-3315
Country	:	US
Telephone Number	:	562-428-1490
Fax Number	:	562-428-1409

Provider Business Practice Location Address
First Line	:	3711 LONG BEACH BLVD
Second Line	:	STE. 200
City	:	LONG BEACH
State	:	CA
Zip	:	90807-3315
Country	:	US
Telephone Number	:	562-428-1490
Fax Number	:	562-428-1409

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/12/2006
Last Update Date	:	07/08/2007

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Directions to “ DR. GUY L TRIMBLE IV DC” Practice Location

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