Individual
REVE BRANDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
13916 LA MAIDA ST, SHERMAN OAKS, CA 91423-1907
(631) 339-5015
Mailing address
13916 LA MAIDA ST, SHERMAN OAKS, CA 91423-1907
(631) 339-5015
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
687781-1
NY
367500000X
Certified Registered Nurse Anesthetist
Primary
NA95001235
CA
Other
Enumeration date
05/24/2019
Last updated
03/06/2024
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