Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | DC27717 | CA |
NPI | 1003010638 |
---|---|
Provider Name | Dr. Brian Conant Austin |
First Address | San Diego, CA 92111-1610 |
Second Address | San Diego, CA 92111-1610 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/06/2007 |
Last Update Date | 13/06/2016 |