Individual
BRANDON M BERRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
IDC
Contact information
Practice address
11123 PEGASUS AVE, SAN DIEGO, CA 92126-4717
(714) 403-3604
Mailing address
11123 PEGASUS AVE, SAN DIEGO, CA 92126-4717
(714) 403-3604
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
06/05/2012
Last updated
06/05/2012
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