Individual provider · Type 1 NPI
Bryan Matthew Brandon
Facial Plastic Surgery Physician · San Clemente, CA
NPI number
1548670482
Active
Practice location
665 Camino De Los Mares # 100
San Clemente, CA 92673-2859
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | 201583 (NC) |
| Facial Plastic Surgery Physician Primary | 207YS0123X | 167465 (CA) |
Facial Plastic Surgery Physician: An otolaryngologist who specializes in facial plastic surgery.
About NPI 1548670482
Bryan Matthew Brandon's National Provider Identifier is 1548670482, issued on Apr 30, 2014. The primary taxonomy on file is Facial Plastic Surgery Physician (207YS0123X), and the practice location is in San Clemente, CA. The record was last updated on Jul 1, 2021.