Provider Demographics
NPI:1093972549
Name:GATTERMAN, BRYAN GALE (DC, DACBR)
Entity Type:Individual
Prefix:DR
First Name:BRYAN
Middle Name:GALE
Last Name:GATTERMAN
Suffix:
Gender:M
Credentials:DC, DACBR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4061 E CASTRO VALLEY BLVD
Mailing Address - Street 2:STE. 150
Mailing Address - City:CASTRO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94552-4840
Mailing Address - Country:US
Mailing Address - Phone:925-803-1300
Mailing Address - Fax:925-828-3422
Practice Address - Street 1:4061 E CASTRO VALLEY BLVD
Practice Address - Street 2:STE. 150
Practice Address - City:CASTRO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:94552-4840
Practice Address - Country:US
Practice Address - Phone:925-803-1300
Practice Address - Fax:925-828-3422
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-21
Last Update Date:2008-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC14920111NR0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0200XChiropractic ProvidersChiropractorRadiology