Dr. Brett Long, Longevity Chiropractic, Inc

Primary specialty

Rehabilitation ChiropractorTaxonomy code 111NR0400X

License

33676 Issued in CA

Legal business name

DR. BRETT LONG, LONGEVITY CHIROPRACTIC, INC

Practice address

22972 El Toro Rd
Lake Forest, CA 92630-4961

Phone

(949) 472-4007

Fax

(949) 586-2225

NPI assigned

Aug 23, 2017

Organization subpart

No

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

Authorized official

Name

Dr. Brett Long, DC

Title

Doctor and Owner of Practice

Phone

(949) 329-8126

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1503446400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1679090559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22972 EL TORO RD",
            "city": "LAKE FOREST",
            "state": "CA",
            "postal_code": "926304961",
            "telephone_number": "949-472-4007",
            "fax_number": "949-586-2225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22972 EL TORO RD",
            "city": "LAKE FOREST",
            "state": "CA",
            "postal_code": "926304961",
            "telephone_number": "949-472-4007",
            "fax_number": "949-586-2225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. BRETT LONG, LONGEVITY CHIROPRACTIC, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-23",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "LONG",
        "authorized_official_first_name": "BRETT",
        "authorized_official_title_or_position": "DOCTOR AND OWNER OF PRACTICE",
        "authorized_official_telephone_number": "949-329-8126",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111NR0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor, Rehabilitation",
            "state": "CA",
            "license": "33676",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Rehabilitation Chiropractor in Lake Forest, CA
• Providers in Lake Forest, CA by specialty
• Rehabilitation Chiropractor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.