MEDICARE: DR. BRANDON DAVID TAKAHASHI D.C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	DC25299	CA

General Provider Information

NPI Number	:	1346253853
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRANDON DAVID TAKAHASHI D.C

Provider Business Mailing Address
First Line	:	11340 W OLYMPIC BLVD
Second Line	:	SUITE 340
City	:	LOS ANGELES
State	:	CA
Zip	:	90064-1608
Country	:	US
Telephone Number	:	310-445-1050
Fax Number	:	310-445-1060

Provider Business Practice Location Address
First Line	:	11340 W OLYMPIC BLVD
Second Line	:	SUITE 340
City	:	LOS ANGELES
State	:	CA
Zip	:	90064-1608
Country	:	US
Telephone Number	:	310-445-1050
Fax Number	:	310-445-1060

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/14/2006
Last Update Date	:	11/14/2012

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