Healthcare Provider Details

I. General information

NPI: 1386779049
Provider Name (Legal Business Name): BRENDAN MICHAEL MURRAY D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/22/2007
Last Update Date: 05/18/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2825 SANTA MONICA BLVD SUITE 101
SANTA MONICA CA
90404-2429
US

IV. Provider business mailing address

PO BOX 270
WOODLAND HILLS CA
91365-0270
US

V. Phone/Fax

Practice location:
  • Phone: 310-998-5800
  • Fax: 310-998-5811
Mailing address:
  • Phone: 310-998-5800
  • Fax: 310-998-5811

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License NumberD.C. 19544
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: