Individual
BRANDON MACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2575 YORBA LINDA BLVD, FULLERTON, CA 92831-1699
(714) 449-7400
Mailing address
2575 YORBA LINDA BLVD, FULLERTON, CA 92831-1699
(714) 449-7400
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
10/25/2019
Last updated
02/18/2021
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