Provider Demographics
NPI:1407027774
Name:TIMOTHY J. GAY
Entity Type:Organization
Organization Name:TIMOTHY J. GAY
Other - Org Name:SOLANA BEACH CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:J
Authorized Official - Last Name:GAY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:858-259-4130
Mailing Address - Street 1:991 LOMAS SANTA FE DR
Mailing Address - Street 2:STE A
Mailing Address - City:SOLANA BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92075-2141
Mailing Address - Country:US
Mailing Address - Phone:858-259-4130
Mailing Address - Fax:858-259-4135
Practice Address - Street 1:991 LOMAS SANTA FE DR STE A
Practice Address - Street 2:
Practice Address - City:SOLANA BEACH
Practice Address - State:CA
Practice Address - Zip Code:92075-2141
Practice Address - Country:US
Practice Address - Phone:858-259-4130
Practice Address - Fax:858-259-4135
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-14
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA30188111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1700837556OtherINDIVIDUAL NPI NUMBER
CA1275710824OtherINDIVIDUAL NPI NUMBER