Individual
DR. BRANDON SHIGERU ITO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D., M.P.H.
Contact information
Practice address
760 WESTWOOD PLZ STE 48-240, LOS ANGELES, CA 90024-5055
(310) 825-0193
Mailing address
5767 W CENTURY BLVD STE 400, LOS ANGELES, CA 90045-5631
(310) 301-8707
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
A121975
CA
2084P0804X
Child & Adolescent Psychiatry Physician
A121975
CA
Other
Enumeration date
05/25/2011
Last updated
07/16/2024
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