Provider Demographics
NPI:1093838062
Name:HINCK, BRIAN LEROY (DC)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:LEROY
Last Name:HINCK
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 1:60 MISSION DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94566-7684
Mailing Address - Country:US
Mailing Address - Phone:925-417-0997
Mailing Address - Fax:925-417-0688
Practice Address - Street 1:60 MISSION DR
Practice Address - Street 2:SUITE A
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94566-7684
Practice Address - Country:US
Practice Address - Phone:925-417-0997
Practice Address - Fax:925-417-0688
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA28493111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor