Brandon Antonissen, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

34287 Issued in CA

Practice address

5 Journey Ste 100
Aliso Viejo, CA 92656-5330

Phone

(949) 228-1147

NPI assigned

Aug 8, 2018

Last updated

Jul 26, 2019By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Antonissen Family Chiropractic

  • Chiropractor
  • San Juan Capistrano, CA
  • NPI 1033687223
  Authorized official Same address or phone

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1533686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564099200000",
    "number": "1063991354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1968 S COAST HWY",
            "address_2": "STE 1073",
            "city": "LAGUNA BEACH",
            "state": "CA",
            "postal_code": "926513681",
            "telephone_number": "949-228-1147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 JOURNEY STE 100",
            "city": "ALISO VIEJO",
            "state": "CA",
            "postal_code": "926565330",
            "telephone_number": "949-228-1147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANTONISSEN",
        "first_name": "BRANDON",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-08-08",
        "last_updated": "2019-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "34287",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Aliso Viejo, CA
• Providers in Aliso Viejo, CA by specialty
• Chiropractor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.