Provider Demographics
NPI:1841972437
Name:GARBENIUS, THIMMY (DC)
Entity type:Individual
Prefix:
First Name:THIMMY
Middle Name:
Last Name:GARBENIUS
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 1:2214 W TOLEDO PL
Mailing Address - Street 2:
Mailing Address - City:LA HABRA
Mailing Address - State:CA
Mailing Address - Zip Code:90631-5082
Mailing Address - Country:US
Mailing Address - Phone:914-536-7744
Mailing Address - Fax:
Practice Address - Street 1:13311 GARDEN GROVE BLVD STE B
Practice Address - Street 2:
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92843-2202
Practice Address - Country:US
Practice Address - Phone:979-218-0359
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-02
Last Update Date:2023-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC36607111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor