Individual
BRANDON M PENN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
310 HARTNELL AVE, REDDING, CA 96002-1800
(530) 244-2223
(530) 244-4799
Mailing address
2234 COLONIAL BLVD, ATTN: PAYER CONTRACTING & RELATIONS, FORT MYERS, FL 33907-1412
(239) 931-7342
(239) 931-7385
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
20A10077
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1295919504
—
CA
01
—
6728967
CIGNA
CA
01
—
P01217048
RAILROAD MCR
CA
Enumeration date
12/21/2007
Last updated
11/06/2013
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