Healthcare Provider Details

I. General information

NPI: 1275466641
Provider Name (Legal Business Name): ZACHARY ROBERT BREWER PPS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/05/2026
Last Update Date: 06/05/2026
Certification Date: 06/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5050 BARRANCA PKWY
IRVINE CA
92604-4698
US

IV. Provider business mailing address

29795 PRESTON DR
LAGUNA NIGUEL CA
92677-2016
US

V. Phone/Fax

Practice location:
  • Phone: 949-936-5287
  • Fax:
Mailing address:
  • Phone: 949-357-3447
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: