Provider Demographics
NPI:1013157619
Name:FOX, BRANDON DAVID (DC)
Entity Type:Individual
Prefix:DR
First Name:BRANDON
Middle Name:DAVID
Last Name:FOX
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 1:3370 COUNTRY CLUB DR
Mailing Address - Street 2:
Mailing Address - City:CAMERON PARK
Mailing Address - State:CA
Mailing Address - Zip Code:95682-8633
Mailing Address - Country:US
Mailing Address - Phone:530-350-7314
Mailing Address - Fax:530-903-4633
Practice Address - Street 1:3370 COUNTRY CLUB DR
Practice Address - Street 2:
Practice Address - City:CAMERON PARK
Practice Address - State:CA
Practice Address - Zip Code:95682-8633
Practice Address - Country:US
Practice Address - Phone:530-350-7314
Practice Address - Fax:530-903-4633
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-23
Last Update Date:2022-11-22
Deactivation Date:2022-08-03
Deactivation Code:
Reactivation Date:2022-11-08
Provider Licenses
StateLicense IDTaxonomies
CADC-30805111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation