Provider Demographics
NPI:1518392521
Name:URSICH, TIMOTHY JOSHUA (DC)
Entity Type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:JOSHUA
Last Name:URSICH
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 1:28633 S WESTERN AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:RANCHO PALOS VERDES
Mailing Address - State:CA
Mailing Address - Zip Code:90275-0827
Mailing Address - Country:US
Mailing Address - Phone:310-832-2622
Mailing Address - Fax:
Practice Address - Street 1:28633 S WESTERN AVE STE 200
Practice Address - Street 2:
Practice Address - City:RANCHO PALOS VERDES
Practice Address - State:CA
Practice Address - Zip Code:90275-0817
Practice Address - Country:US
Practice Address - Phone:310-832-2622
Practice Address - Fax:310-832-2621
Is Sole Proprietor?:No
Enumeration Date:2013-09-10
Last Update Date:2021-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA32718111NP0017X, 111NR0400X, 111NS0005X, 111NX0800X, 111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NP0017XChiropractic ProvidersChiropractorPediatric Chiropractor
No111NR0400XChiropractic ProvidersChiropractorRehabilitation
No111NS0005XChiropractic ProvidersChiropractorSports Physician
No111NX0800XChiropractic ProvidersChiropractorOrthopedic