MEDICARE: TIM FRANKS INC

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	111NR0400X	Rehabilitation Chiropractor	CA22671	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	ZZZ561600Z	OTHER	CA	BLUE SHIELD ID

General Provider Information

NPI Number	:	1689876609
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TIM FRANKS INC

Provider Business Mailing Address
First Line	:	18102 IRVINE BLVD STE 209
Second Line	:
City	:	TUSTIN
State	:	CA
Zip	:	92780-3424
Country	:	US
Telephone Number	:	714-505-0973
Fax Number	:	714-505-3246

Provider Business Practice Location Address
First Line	:	18102 IRVINE BLVD STE 209
Second Line	:
City	:	TUSTIN
State	:	CA
Zip	:	92780-3424
Country	:	US
Telephone Number	:	714-505-0973
Fax Number	:	714-505-3246

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. TIM J FRANKS
Credential	:	D.C.
Telephone Number	:	714-505-0973

Provider Enumeration Date	:	06/01/2007
Last Update Date	:	08/22/2020

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