Provider Demographics
NPI:1396228789
Name:VANSETERS, BRANDON JAY (DC)
Entity Type:Individual
Prefix:DR
First Name:BRANDON
Middle Name:JAY
Last Name:VANSETERS
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 1:4425 JAMBOREE RD STE 261
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-3002
Mailing Address - Country:US
Mailing Address - Phone:949-423-6127
Mailing Address - Fax:
Practice Address - Street 1:4425 JAMBOREE RD STE 261
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-3002
Practice Address - Country:US
Practice Address - Phone:949-423-6127
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-11
Last Update Date:2020-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA34041111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor