Provider Demographics
NPI:1467662312
Name:HAAS, BRYAN JAMES (DC)
Entity Type:Individual
Prefix:DR
First Name:BRYAN
Middle Name:JAMES
Last Name:HAAS
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 1:8046 BROWNSTONE ST
Mailing Address - Street 2:
Mailing Address - City:SUNLAND
Mailing Address - State:CA
Mailing Address - Zip Code:91040-2101
Mailing Address - Country:US
Mailing Address - Phone:818-795-4116
Mailing Address - Fax:818-957-4011
Practice Address - Street 1:2255 HONOLULU AVE STE A2
Practice Address - Street 2:
Practice Address - City:MONTROSE
Practice Address - State:CA
Practice Address - Zip Code:91020-1635
Practice Address - Country:US
Practice Address - Phone:818-957-1217
Practice Address - Fax:818-957-4011
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2021-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC24395111N00000X
CA95018853363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No111N00000XChiropractic ProvidersChiropractor