Provider Demographics
NPI:1053554139
Name:PATTERSON, BRENT MATTHEW (DC)
Entity type:Individual
Prefix:
First Name:BRENT
Middle Name:MATTHEW
Last Name:PATTERSON
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 1:2352 ALTISMA WAY APT 7
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92009-6317
Mailing Address - Country:US
Mailing Address - Phone:858-405-9299
Mailing Address - Fax:760-438-8782
Practice Address - Street 1:2352 ALTISMA WAY APT 7
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92009-6317
Practice Address - Country:US
Practice Address - Phone:858-405-9299
Practice Address - Fax:760-438-8782
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-20
Last Update Date:2009-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC-31241111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor