Individual
BRANDON SHAPOOR PORSANDEH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
100 W BROADWAY, LONG BEACH, CA 90802-4431
(562) 243-6492
Mailing address
100 W BROADWAY, LONG BEACH, CA 90802-4431
(562) 243-6492
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
ASW70255
CA
225400000X
Rehabilitation Practitioner
ASW27600
CA
Other
Enumeration date
10/06/2008
Last updated
12/12/2016
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