Provider Demographics
NPI:1508975327
Name:BISCOTTI, BRIAN STEPHEN (DC)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:STEPHEN
Last Name:BISCOTTI
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:7556 CORALWOOD CT
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92880-9046
Mailing Address - Country:US
Mailing Address - Phone:951-520-0715
Mailing Address - Fax:909-946-1872
Practice Address - Street 1:886 W FOOTHILL BLVD
Practice Address - Street 2:SUITE E
Practice Address - City:UPLAND
Practice Address - State:CA
Practice Address - Zip Code:91786-3769
Practice Address - Country:US
Practice Address - Phone:909-946-2673
Practice Address - Fax:909-946-1872
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2008-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC25410111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor