| Doctor Name: | BRANDON DA VALLE |
| NPI Number: | 1528122330 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | D.O. |
| License Number: | CARESIDENT INTERN |
| Business Practice Address: | 34800 Bob Wilson Dr Nmcsd San Diego, CA - 921341098 |
| Business Phone Number: | 8885039045 |
| Business Fax Number: | |
| Mailing Address: | 3267 E Fox Run Way, SAN DIEGO |
| State: | CA |
| Postal Code: | 921117746 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 12/19/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | CARESIDENT INTERN |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |