Provider Demographics
NPI:1780706150
Name:BREWSTER, MARK FRANCIS (DC)
Entity type:Individual
Prefix:DR
First Name:MARK
Middle Name:FRANCIS
Last Name:BREWSTER
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 1:2941 SUNRISE BLVD
Mailing Address - Street 2:SUITE 150
Mailing Address - City:RANCHO CORDOVA
Mailing Address - State:CA
Mailing Address - Zip Code:95742-6551
Mailing Address - Country:US
Mailing Address - Phone:916-638-2184
Mailing Address - Fax:916-638-2324
Practice Address - Street 1:2941 SUNRISE BLVD
Practice Address - Street 2:SUITE 150
Practice Address - City:RANCHO CORDOVA
Practice Address - State:CA
Practice Address - Zip Code:95742-6551
Practice Address - Country:US
Practice Address - Phone:916-638-2184
Practice Address - Fax:916-638-2324
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA17444111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC0174440Medicare ID - Type Unspecified