Provider Demographics
NPI:1366467334
Name:TRIMBLE, GUY L IV (DC)
Entity Type:Individual
Prefix:DR
First Name:GUY
Middle Name:L
Last Name:TRIMBLE
Suffix:IV
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3711 LONG BEACH BLVD
Mailing Address - Street 2:STE. 200
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90807-3315
Mailing Address - Country:US
Mailing Address - Phone:562-428-1490
Mailing Address - Fax:562-428-1409
Practice Address - Street 1:3711 LONG BEACH BLVD
Practice Address - Street 2:STE. 200
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90807-3315
Practice Address - Country:US
Practice Address - Phone:562-428-1490
Practice Address - Fax:562-428-1409
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC26820111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA970354OtherQME