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NPI 1336521715

NPI 1336521715 : BRANDON MORNING : MODESTO, CA

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General NPI Number Information
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    NPI Number           |    1336521715
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    Entity Type          |    Individual 
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    Provider Name        |    BRANDON MORNING
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    06/23/2015
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    Last Update Date     |    06/23/2015
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Provider Practice Location Address
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    Address Line         |    1441 FLORIDA AVE 
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    City                 |    MODESTO
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    State                |    CA
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    Zip                  |    95350-4404
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    Country              |    US
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    Telephone            |    209-576-3622
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    1880 SALMON LN 
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    City                 |    MANTECA
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    State                |    CA
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    Zip                  |    95337-7997
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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        |    183500000X
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    Taxonomy Name        |    Pharmacist
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    License Number       |    70228
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    License Number State |    CA
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Taxonomy #2
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    Taxonomy Code        |    183500000X
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    Taxonomy Name        |    Pharmacist
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    License Number       |    15730
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    License Number State |    AL
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