Individual
BRANDON EDWARD MCCULLOUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
6137 WALNUT GROVE CT, RANCHO CUCAMONGA, CA 91739-2267
(909) 969-4387
Mailing address
6137 WALNUT GROVE CT, RANCHO CUCAMONGA, CA 91739-2267
(909) 969-4387
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
05/13/2020
Last updated
05/13/2020
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