Healthcare Provider Details

I. General information

NPI: 1982306783
Provider Name (Legal Business Name): BRANDON FEIN DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/17/2023
Last Update Date: 03/17/2023
Certification Date: 03/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 LOMBARD ST STE 2
SAN FRANCISCO CA
94111-1169
US

IV. Provider business mailing address

3629 HAPPY VALLEY RD
LAFAYETTE CA
94549-3048
US

V. Phone/Fax

Practice location:
  • Phone: 415-421-1115
  • Fax:
Mailing address:
  • Phone: 831-539-6239
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License NumberDC36574
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: