Provider Demographics
NPI:1295912491
Name:TIMOTHY L GOOING D C INC
Entity type:Organization
Organization Name:TIMOTHY L GOOING D C INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:GOOING
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:949-586-8525
Mailing Address - Street 1:25260 E LA PAZ RD
Mailing Address - Street 2:STE #K
Mailing Address - City:LAGUNA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:92653
Mailing Address - Country:US
Mailing Address - Phone:949-586-8525
Mailing Address - Fax:949-586-9892
Practice Address - Street 1:23695 BIRTCHER DR
Practice Address - Street 2:
Practice Address - City:LAKE FOREST
Practice Address - State:CA
Practice Address - Zip Code:92630-1782
Practice Address - Country:US
Practice Address - Phone:949-586-8525
Practice Address - Fax:949-586-9892
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-30
Last Update Date:2024-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC19132111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC19132AMedicare Oscar/Certification
CAU60797Medicare UPIN