Brandon Mack
Physician Assistant in Fullerton, CA. Individual provider (NPI-1).
NPI number1962045666
StatusActive
Last updated in NPPESFeb 18, 2021
Details
- NPI
- 1962045666
- Entity type
- Individual (NPI-1)
- Name
- Brandon Mack
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Oct 25, 2019
- Certification date
- Jan 22, 2021
- Last updated
- Feb 18, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | – | – | Yes |
Practice location
2575 Yorba Linda BlvdFullerton, CA 92831-1699
Phone 714-449-7400
Mailing address
2575 Yorba Linda BlvdFullerton, CA 92831-1699
Phone 714-449-7400
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All 142 Physician Assistant providers in Fullerton · All 6,385 providers in Fullerton
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