Provider Demographics
NPI:1598100901
Name:BROWN, TED DOUGLAS (DC)
Entity Type:Individual
Prefix:DR
First Name:TED
Middle Name:DOUGLAS
Last Name:BROWN
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 1:5510 SUNOL BLVD
Mailing Address - Street 2:SUITE 5
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94566-8857
Mailing Address - Country:US
Mailing Address - Phone:510-472-7748
Mailing Address - Fax:
Practice Address - Street 1:5510 SUNOL BLVD
Practice Address - Street 2:SUITE 5
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94566-8857
Practice Address - Country:US
Practice Address - Phone:510-472-7748
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-30
Last Update Date:2013-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC 32187111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor