Provider Demographics
NPI:1114432986
Name:BUSER, ANDREW BRADLEY (DC, CSCS)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:BRADLEY
Last Name:BUSER
Suffix:
Gender:M
Credentials:DC, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2120 MAIN ST STE 130
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92648-6417
Mailing Address - Country:US
Mailing Address - Phone:657-215-5642
Mailing Address - Fax:
Practice Address - Street 1:2120 MAIN ST STE 130
Practice Address - Street 2:
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92648-6417
Practice Address - Country:US
Practice Address - Phone:657-215-5642
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-12-02
Last Update Date:2017-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA33114111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation