Provider Demographics
NPI:1396101036
Name:TIMANUS, MICHAEL II (CATC)
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:
Last Name:TIMANUS
Suffix:II
Gender:M
Credentials:CATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:546 S CITRON ST
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92805-4420
Mailing Address - Country:US
Mailing Address - Phone:714-381-0432
Mailing Address - Fax:
Practice Address - Street 1:546 S CITRON ST
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92805-4420
Practice Address - Country:US
Practice Address - Phone:714-381-0432
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-11
Last Update Date:2016-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator