Individual
BRANDIE LASALA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
26161 LA PAZ RD STE 115, MISSION VIEJO, CA 92691-5334
(949) 206-0001
Mailing address
26161 LA PAZ RD STE 115, MISSION VIEJO, CA 92691-5334
(717) 531-8521
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MT198165
PA
Other
Enumeration date
06/14/2010
Last updated
11/01/2019
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