Provider Demographics
NPI:1750791745
Name:ANDREWS, BRAD ROBERT (DC)
Entity type:Individual
Prefix:
First Name:BRAD
Middle Name:ROBERT
Last Name:ANDREWS
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 1:820 HARBOR CLIFF WAY UNIT 253
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92054-2280
Mailing Address - Country:US
Mailing Address - Phone:760-450-8499
Mailing Address - Fax:
Practice Address - Street 1:1885 NATIONAL AVE
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92113-1845
Practice Address - Country:US
Practice Address - Phone:619-238-0096
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-30
Last Update Date:2014-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA32479111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor