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Individual

DR. BRIAN S. OTA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
150 E FREMONT AVE, SUNNYVALE, CA 94087-3201
(408) 720-0941
(408) 720-0943
Mailing address
1052 E EL CAMINO REAL, SUNNYVALE, CA 94087-3754
(408) 248-7960
(408) 554-0654

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
23084
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
ZZZ40577Z
BLUE SHIELD
CA
Enumeration date
12/18/2007
Last updated
11/08/2010
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