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General NPI Number Information
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NPI Number | 1316822471
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Entity Type | Individual
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Provider Name | BRANDON DEVANTE MAGEESMITH RN
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Gender | Male
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Dates
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Enumeration Date | 08/07/2025
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Last Update Date | 08/07/2025
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Provider Practice Location Address
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Address Line | 218 OLIVE HILL DR
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City | SAN JOSE
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State | CA
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Zip | 95125-6600
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Country | US
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Telephone | 209-650-5607
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Fax |
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Provider Business Mailing Address
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Address Line | 218 OLIVE HILL DR
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City | SAN JOSE
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State | CA
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Zip | 95125-6600
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Country | US
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Telephone |
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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 | 163WP2201X
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Taxonomy Name | Ambulatory Care Registered Nurse
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License Number | 95317653
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License Number State | CA
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