Provider Demographics
NPI:1346232824
Name:NOBLE, TIMOTHY ROGER (DC)
Entity Type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:ROGER
Last Name:NOBLE
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 1:5769 E SANTA ANA CANYON RD
Mailing Address - Street 2:SUITE P
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92807-3233
Mailing Address - Country:US
Mailing Address - Phone:714-974-3700
Mailing Address - Fax:714-282-1830
Practice Address - Street 1:5769 E SANTA ANA CANYON RD
Practice Address - Street 2:SUITE P
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92807-3233
Practice Address - Country:US
Practice Address - Phone:714-974-3700
Practice Address - Fax:714-282-1830
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-19
Last Update Date:2010-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA18565111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAT91741Medicare ID - Type Unspecified