Individual
MR. BRANDON LUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
13075 BLACKBIRD ST, GARDEN GROVE, CA 92843-2902
(714) 530-6322
Mailing address
15 WINTERGREEN, IRVINE, CA 92604-2800
(808) 352-7783
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
303202
CA
Other
Enumeration date
09/05/2023
Last updated
09/05/2023
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