Individual
BRANDON GONZALEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
12450 VAN NUYS BLVD STE 200, PACOIMA, CA 91331-1393
(818) 896-1161
Mailing address
12450 VAN NUYS BLVD STE 200, PACOIMA, CA 91331-1393
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1954
—
CA
05
—
6758
—
CA
05
—
7068
—
CA
05
—
7420
—
CA
Enumeration date
07/31/2023
Last updated
09/20/2023
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