Provider Demographics
NPI:1780745810
Name:PAYNE, BRYAN (DC)
Entity type:Individual
Prefix:DR
First Name:BRYAN
Middle Name:
Last Name:PAYNE
Suffix:
Gender:
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20406 REDWOOD RD STE B
Mailing Address - Street 2:
Mailing Address - City:CASTRO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94546-4317
Mailing Address - Country:US
Mailing Address - Phone:510-886-7515
Mailing Address - Fax:510-886-2413
Practice Address - Street 1:20406 REDWOOD RD STE B
Practice Address - Street 2:
Practice Address - City:CASTRO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:94546-4317
Practice Address - Country:US
Practice Address - Phone:510-886-7515
Practice Address - Fax:510-886-2413
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-13
Last Update Date:2025-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC 26468111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor