Individual
BRANDON ISARIYAWONGSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5893 COPLEY DR, SAN DIEGO, CA 92111-7906
(858) 616-5417
Mailing address
5893 COPLEY DR, SAN DIEGO, CA 92111-7906
(858) 616-5417
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
131363
CA
Other
Enumeration date
04/07/2008
Last updated
11/29/2021
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