Healthcare Provider Details

I. General information

NPI: 1255099628
Provider Name (Legal Business Name): BRANDON SEAN TRUJILLO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/02/2021
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 E MCDOWELL RD
PHOENIX AZ
85006-2612
US

IV. Provider business mailing address

2901 N CENTRAL AVE STE 160
PHOENIX AZ
85012-2702
US

V. Phone/Fax

Practice location:
  • Phone: 602-839-2000
  • Fax:
Mailing address:
  • Phone: 602-747-4000
  • Fax: 505-272-2776

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License NumberH0016
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: