Active NPI
Brett D Long, D.C.
- Rehabilitation Chiropractor
- Lake Forest, CA
National Provider Identifier
1750837605
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rehabilitation Chiropractor
- License
- 33676
- Practice address
- 22972 El Toro Rd
Lake Forest, CA 92630-4961 - Phone
- (949) 329-8126
- Fax
- (949) 586-2225
- NPI assigned
- Aug 31, 2016
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rehabilitation Chiropractor | 111NR0400X | 33676 | CA | Primary |
Addresses
Primary practice location
22972 El Toro Rd
Lake Forest, CA 92630-4961
Mailing address
22972 El Toro Rd
Lake Forest, CA 92630-4961
Phone (949) 329-8126
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 33676 | CA | MD | Rehabilitation Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1472601600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1472601600000",
"number": "1750837605",
"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": "949-329-8126",
"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": "949-329-8126",
"fax_number": "949-586-2225"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LONG",
"first_name": "BRETT",
"middle_name": "D",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-08-31",
"last_updated": "2016-08-31",
"status": "A"
},
"taxonomies": [
{
"code": "111NR0400X",
"taxonomy_group": "",
"desc": "Chiropractor, Rehabilitation",
"state": "CA",
"license": "33676",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lake Forest, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.