Individual
BRANDON REYES COLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2440 RIVER RD STE 140, NORCO, CA 92860-2402
(951) 225-1783
Mailing address
7049 RIVERSIDE DR, CHINO, CA 91710-9011
(951) 283-2246
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
RDA90918
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
RDA90918
—
CA
Enumeration date
07/17/2019
Last updated
07/17/2019
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