Provider Demographics
NPI:1275758211
Name:BRASS, MICHAEL DAVID (DC)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:DAVID
Last Name:BRASS
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 1:281 E HAMILTON AVE
Mailing Address - Street 2:SUITE #4
Mailing Address - City:CAMPBELL
Mailing Address - State:CA
Mailing Address - Zip Code:95008-0232
Mailing Address - Country:US
Mailing Address - Phone:408-378-7800
Mailing Address - Fax:408-378-7805
Practice Address - Street 1:281 E HAMILTON AVE
Practice Address - Street 2:SUITE #4
Practice Address - City:CAMPBELL
Practice Address - State:CA
Practice Address - Zip Code:95008-0232
Practice Address - Country:US
Practice Address - Phone:408-378-7800
Practice Address - Fax:408-378-7805
Is Sole Proprietor?:No
Enumeration Date:2007-04-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA18743111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor