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General NPI Number Information
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NPI Number | 1063500312
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Entity Type | Individual
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Provider Name | ROBERT P BRANDON MPT ATC
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Gender | Male
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Dates
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Enumeration Date | 10/11/2006
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Last Update Date | 03/19/2024
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Provider Practice Location Address
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Address Line | 3273 CLAREMONT WAY STE 101
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City | NAPA
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State | CA
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Zip | 94558-3328
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Country | US
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Telephone | 707-603-1030
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Fax | 707-251-1463
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Provider Business Mailing Address
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Address Line | 3160 KINGSTON AVE
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City | NAPA
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State | CA
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Zip | 94558-4459
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Country | US
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Telephone | 707-294-2868
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT 21197
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License Number State | CA
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