Provider Demographics
NPI:1578340287
Name:TOMBERLIN, MORGAN MICHELLE (DC)
Entity Type:Individual
Prefix:DR
First Name:MORGAN
Middle Name:MICHELLE
Last Name:TOMBERLIN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:840 MAIN ST STE B2
Mailing Address - Street 2:
Mailing Address - City:HALF MOON BAY
Mailing Address - State:CA
Mailing Address - Zip Code:94019-2187
Mailing Address - Country:US
Mailing Address - Phone:650-720-5989
Mailing Address - Fax:
Practice Address - Street 1:840 MAIN ST STE B2
Practice Address - Street 2:
Practice Address - City:HALF MOON BAY
Practice Address - State:CA
Practice Address - Zip Code:94019-2187
Practice Address - Country:US
Practice Address - Phone:650-720-5989
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-14
Last Update Date:2023-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC36741111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty