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Individual

BRENDAN C HICKEY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
COLLEGE MEDICAL CENTER- 2776 PACIFIC AVE, MEDICA STAFFING OFFICE, LONG BEACH, CA 90806
(562) 997-2330
(562) 595-6985
Mailing address
COLLEGE MEDICAL CENTER- 2776 PACIFIC AVE, MEDICA STAFFING OFFICE, LONG BEACH, CA 90806
(562) 997-2330
(562) 595-6985

Taxonomy

Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
549249
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
$$$$$$$$$
SSN
Enumeration date
03/29/2011
Last updated
12/05/2019
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