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BRIAN GORDON DC LAC ACUPUNCTURE PROFESSIONAL CORPORATION NPI 1629271846


NPI Information

NPI: 1629271846
Provider Name: BRIAN GORDON DC LAC ACUPUNCTURE PROFESSIONAL CORPORATION

Doing Business As: ACTIVE CARE SPINE CENTER

Classification: Chiropractor - 111N00000X
Entity Type: Organization
Address:
5363 BALBOA BLVD
SUITE #439
ENCINO, CA
ZIP 91316
Phone: (818) 401-3295
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BRIAN GORDON DC LAC ACUPUNCTURE PROFESSIONAL CORPORATION is a chiropractor in Encino, CA. The provider is a provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. BRIAN GORDON DC LAC ACUPUNCTURE PROFESSIONAL CORPORATION NPI is 1629271846. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Active Care Spine Center.

The provider's business location address is:

5363 BALBOA BLVD
SUITE #439
ENCINO, CA
ZIP 91316-805
Phone: (818) 401-3295
Fax: (818) 387-6142

The provider's authorized official is Brian Bernard Gordon .
The authorized official title is President and has the following contact phone number (818) 386-8835.

The enumeration date for this NPI number is 6/6/2007 and was last updated on 6/17/2016.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1171100000XAcupuncturistAC-13010CALIFORNIANo
2111N00000XChiropractorDC-29620CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1DC29620OTHERCALIFORNIAMEDICARE PTAN
2V06023MEDICARE UPINCALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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