Brian Anthony, DC
Individual provider Active NPI Chiropractor · Soquel, CA
NPI 1083732044 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1083732044
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- DC013732 (CA)
- Practice address
- 3051 Porter St
Soquel, CA 95073-2233 - Phone
- (831) 479-0255
- Fax
- (831) 479-9138
- NPI assigned
- Mar 27, 2007
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110311000428 | CA | Practitioner - Chiropractic | 0446432405 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DC013732 | CA | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Brian Anthony Chiropractic Inc | Chiropractor | Current |
Accepting new patients |
Locations
3051 Porter St
Soquel, CA 95073
Phone (831) 479-0255
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | DC013732 | CA | Yes |
Addresses
Primary practice location
3051 Porter St
Soquel, CA 95073-2233
Mailing address
3051 Porter St
Soquel, CA 95073-2233
Phone (831) 479-0255
Other providers in Soquel, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.