Individual
BRENDEN F PANZARELLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
521 EAST HAM LN, F, LODI, CA 95242
(209) 333-0905
Mailing address
817 COFFEE RD, C3, MODESTO, CA 95355
(209) 529-9603
(209) 529-6610
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
A49603
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A496031
—
CA
Enumeration date
08/01/2006
Last updated
07/08/2007
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