Individual
MR. BRANDON SCOTT AVERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
19801 TOMAHAWK RD, APPLE VALLEY, CA 92307-5013
(760) 628-9195
(760) 628-9195
Mailing address
19801 TOMAHAWK RD, APPLE VALLEY, CA 92307-5013
(760) 628-9195
(760) 628-9195
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
336427614
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
336427614
LICENSED FACILITY NUMBER
CA
Enumeration date
07/03/2017
Last updated
07/21/2022
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