MEDICARE: BRANDEN GUTLAY YEO DC

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	33945	CA

General Provider Information

NPI Number	:	1457870560
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRANDEN GUTLAY YEO DC

Provider Business Mailing Address
First Line	:	1510 FRONT ST STE 210
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92101-2945
Country	:	US
Telephone Number	:	858-375-6794
Fax Number	:

Provider Business Practice Location Address
First Line	:	239 S LA CIENEGA BLVD STE 201
Second Line	:
City	:	BEVERLY HILLS
State	:	CA
Zip	:	90211-3319
Country	:	US
Telephone Number	:	310-880-1659
Fax Number	:	866-509-1539

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

Provider Enumeration Date	:	09/11/2017
Last Update Date	:	01/02/2019

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Directions to “ BRANDEN GUTLAY YEO DC” Practice Location

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