Provider Demographics
NPI:1477685451
Name:BUCHANAN, BRIAN S (DC)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:S
Last Name:BUCHANAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:SLO
Other - Middle Name:
Other - Last Name:PEOPLE'S CHIROPRACTIC
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:965 MONTEREY ST
Mailing Address - Street 2:
Mailing Address - City:SAN LUIS OBISPO
Mailing Address - State:CA
Mailing Address - Zip Code:93401-3204
Mailing Address - Country:US
Mailing Address - Phone:805-786-4420
Mailing Address - Fax:
Practice Address - Street 1:965 MONTEREY ST
Practice Address - Street 2:
Practice Address - City:SAN LUIS OBISPO
Practice Address - State:CA
Practice Address - Zip Code:93401-3204
Practice Address - Country:US
Practice Address - Phone:805-786-4420
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-12
Last Update Date:2012-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC26536111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC26536Medicare ID - Type Unspecified