Individual
BRANDON KYLE PORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
8700 GRACIE ALLEN DR, LOS ANGELES, CA 90048-3811
(310) 423-3277
Mailing address
21885 BIRCHWOOD, MISSION VIEJO, CA 92692-4223
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
CA
Other
Enumeration date
05/24/2017
Last updated
05/24/2017
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