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Individual

BRANDI L DIDOMINICK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
2946 E BANNER GATEWAY DR, GILBERT, AZ 85234-2165
(480) 256-6444
(480) 256-3682
Mailing address
2946 E BANNER GATEWAY DR, GILBERT, AZ 85234-2165
(480) 256-6444
(480) 256-3682

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
7224
AZ
363AM0700X
Medical Physician Assistant
Primary
7224
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
469444
AZ
Enumeration date
08/12/2018
Last updated
10/10/2025
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