Provider Demographics
NPI:1265852578
Name:SALCIDO, BRADY (DC)
Entity Type:Individual
Prefix:
First Name:BRADY
Middle Name:
Last Name:SALCIDO
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 1:2660 TOWNSGATE RD
Mailing Address - Street 2:SUITE 760
Mailing Address - City:WESTLAKE VILLAGE
Mailing Address - State:CA
Mailing Address - Zip Code:91361-2714
Mailing Address - Country:US
Mailing Address - Phone:805-379-3653
Mailing Address - Fax:
Practice Address - Street 1:2660 TOWNSGATE RD
Practice Address - Street 2:SUITE 760
Practice Address - City:WESTLAKE VILLAGE
Practice Address - State:CA
Practice Address - Zip Code:91361-2714
Practice Address - Country:US
Practice Address - Phone:805-379-3653
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-25
Last Update Date:2015-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA32830111N00000X, 111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor