Healthcare Provider Details

I. General information

NPI: 1184245235
Provider Name (Legal Business Name): BRANDEN ANTHONY HAN DO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/29/2020
Last Update Date: 02/10/2025
Certification Date: 02/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 N CAMPBELL AVE
TUCSON AZ
85724-0001
US

IV. Provider business mailing address

1500 N CAMPBELL AVE
TUCSON AZ
85724-0001
US

V. Phone/Fax

Practice location:
  • Phone: 520-874-7520
  • Fax: 520-874-7539
Mailing address:
  • Phone: 520-874-7520
  • Fax: 520-874-7539

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberR3359
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number22523
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: