Individual
BRANDON L TULLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Contact information
Practice address
600 COFFEE RD, MODESTO, CA 95355-4201
(209) 524-1211
Mailing address
600 COFFEE RD, MODESTO, CA 95355-4201
(209) 524-1211
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
E44180
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000E44180
—
CA
Enumeration date
05/04/2006
Last updated
02/22/2011
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