# BRANDON SCOTT FUNK

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1396785390
- **Gender:** Man
- **Credential:** PA-C

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363A00000X | Physician Assistant | 1465 | OK | Yes |
| 363A00000X | Physician Assistant | PA17988 | CA | — |

## Other

- **Enumeration date:** 06/07/2006
- **Last updated:** 09/08/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 200201770A | — | OK |
