Individual
DR. BRYN JARALD HENDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
615 E CHAPMAN AVE, ORANGE, CA 92866-1643
(714) 639-4012
(714) 639-4018
Mailing address
615 E CHAPMAN AVE, ORANGE, CA 92866-1643
(714) 639-4012
(714) 639-4018
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
20A4401
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
020A44010
—
CA
Enumeration date
06/22/2006
Last updated
08/25/2020
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