Provider Demographics
NPI:1841327020
Name:GOOING, TIMOTHY L (DC)
Entity type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:L
Last Name:GOOING
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 1:25260 E LA PAZ RD
Mailing Address - Street 2:SUITE #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 1:25260 E LA PAZ RD
Practice Address - Street 2:STE #K
Practice Address - City:LAGUNA HILLS
Practice Address - State:CA
Practice Address - Zip Code:92653
Practice Address - Country:US
Practice Address - Phone:949-586-8525
Practice Address - Fax:949-586-8525
Is Sole Proprietor?:No
Enumeration Date:2007-02-27
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC19132111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA330769883Medicaid
U60797Medicare UPIN