Provider Demographics
NPI:1699703207
Name:NEUBRAND, CHAD MICHAEL (PT)
Entity type:Individual
Prefix:
First Name:CHAD
Middle Name:MICHAEL
Last Name:NEUBRAND
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6699 ALVARADO RD
Mailing Address - Street 2:SUITE 2100
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92120-5238
Mailing Address - Country:US
Mailing Address - Phone:619-229-3909
Mailing Address - Fax:619-229-3902
Practice Address - Street 1:6699 ALVARADO RD
Practice Address - Street 2:SUITE 2100
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92120-5238
Practice Address - Country:US
Practice Address - Phone:619-229-3909
Practice Address - Fax:619-229-3902
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2010-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA19389225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW17215Medicare PIN
CABR511ZMedicare UPIN
CAW12026Medicare PIN
CAWPT19389AMedicare PIN