Individual
DR. BRANDON JAMES SLADE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
1551 BISHOP ST, SAN LUIS OBISPO, CA 93401-4635
(805) 543-7788
(805) 543-7828
Mailing address
1551 BISHOP ST, SAN LUIS OBISPO, CA 93401-4635
(805) 543-7788
(805) 543-7828
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
E4945
CA
213ES0131X
Foot Surgery Podiatrist
41000226A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
FH048Z
PTAN
CA
Enumeration date
11/17/2008
Last updated
09/12/2011
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