Healthcare Provider Details

I. General information

NPI: 1457163362
Provider Name (Legal Business Name): BRANDON NICHOLAS GESSERT DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/27/2025
Last Update Date: 02/04/2025
Certification Date: 02/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3011 CITRUS CIR STE 102
WALNUT CREEK CA
94598-2671
US

IV. Provider business mailing address

3011 CITRUS CIR STE 102
WALNUT CREEK CA
94598-2671
US

V. Phone/Fax

Practice location:
  • Phone: 925-947-1507
  • Fax:
Mailing address:
  • Phone: 925-947-1507
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License Number35069
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number35069
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: