Doctor Name: | BRANDON L SIMMONS |
NPI Number: | 1003117318 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | D1361389 |
Business Practice Address: | 4735 Beacon Rd Paso Robles, CA - 934469286 |
Business Phone Number: | 8052381276 |
Business Fax Number: | |
Mailing Address: | 4735 Beacon Rd, PASO ROBLES |
State: | CA |
Postal Code: | 934469286 |
Phone Number: | 8052381276 |
Fax Number: | |
NPI Enumeration Date: | 11/03/2010 |
NPI Last Update Date: | 11/03/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 172A00000X |
License Number: | D1361389 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | CA |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Driver |
Taxonomy Specialization: | |
Taxonomy Definition: | A person employed to operate a motor vehicle as a carrier of persons or property. |