Individual
MR. BRANDON CHRISTOPHER MARINO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPT
Contact information
Practice address
8939 LA MESA BLVD, STE 1, LA MESA, CA 91942-9057
(619) 464-1352
(619) 464-7255
Mailing address
8700 MELLMANOR DR, LA MESA, CA 91942-3152
(619) 464-1352
(619) 464-7255
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT25976
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PT25976
REG PHYSICAL THERAPIST
CA
Enumeration date
10/12/2006
Last updated
10/26/2010
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