Provider Demographics
NPI:1235723685
Name:GOOING, JOHN MAXWELL (DC)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:MAXWELL
Last Name:GOOING
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23695 BIRTCHER DR STE A
Mailing Address - Street 2:
Mailing Address - City:LAKE FOREST
Mailing Address - State:CA
Mailing Address - Zip Code:92630-1782
Mailing Address - Country:US
Mailing Address - Phone:949-586-8525
Mailing Address - Fax:
Practice Address - Street 1:23695 BIRTCHER DR STE A
Practice Address - Street 2:
Practice Address - City:LAKE FOREST
Practice Address - State:CA
Practice Address - Zip Code:92630-1782
Practice Address - Country:US
Practice Address - Phone:949-586-8525
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-25
Last Update Date:2021-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA35023111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA35023OtherDO NOT HAVE ANY OTHER IDENTIFIERS