Provider Demographics
NPI:1255541389
Name:FAUCRET, BERTRAND HUGUES (DC)
Entity type:Individual
Prefix:DR
First Name:BERTRAND
Middle Name:HUGUES
Last Name:FAUCRET
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 1:7055 CORDGRASS CT
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92011-3973
Mailing Address - Country:US
Mailing Address - Phone:760-431-0085
Mailing Address - Fax:
Practice Address - Street 1:119 N EL CAMINO REAL STE F
Practice Address - Street 2:
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024-5397
Practice Address - Country:US
Practice Address - Phone:760-944-3300
Practice Address - Fax:760-944-8581
Is Sole Proprietor?:No
Enumeration Date:2007-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA11900111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWDC11900AMedicare ID - Type Unspecified