Healthcare Provider Details

I. General information

NPI: 1306541289
Provider Name (Legal Business Name): BRANDON HIRATA DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/31/2023
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4950 BARRANCA PKWY STE 205A
IRVINE CA
92604-8649
US

IV. Provider business mailing address

PO BOX 1213
COSTA MESA CA
92628-1213
US

V. Phone/Fax

Practice location:
  • Phone: 949-243-2585
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number6201
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: