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General NPI Number Information
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NPI Number | 1265126528
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Entity Type | Individual
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Provider Name | BRANDON JULIAN ROCHA DPM
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Gender | Male
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Dates
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Enumeration Date | 06/07/2023
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Last Update Date | 06/12/2023
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Provider Practice Location Address
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Address Line | 1720 E CESAR E CHAVEZ AVE
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City | LOS ANGELES
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State | CA
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Zip | 90033-2414
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Country | US
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Telephone | 323-268-5000
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Fax |
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Provider Business Mailing Address
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Address Line | 10789 OHIO AVE APT 4
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City | LOS ANGELES
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State | CA
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Zip | 90024-5054
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Country | US
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Telephone | 702-689-2342
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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 | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | EL7109
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License Number State | CA
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