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General NPI Number Information
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NPI Number | 1356263073
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Entity Type | Individual
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Provider Name | ISAIAH XAVIER BRINDAMOUR PA-C
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Gender | Male
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Dates
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Enumeration Date | 07/27/2026
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Last Update Date | 07/27/2026
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Provider Practice Location Address
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Address Line | NAVAL HOSPITAL CAMP PENDLETON BOX 555191
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City | CAMP PENDLETON
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State | CA
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Zip | 92055
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Country | US
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Telephone | 760-725-1288
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Fax |
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Provider Business Mailing Address
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Address Line | 3717 MORMON COULEE RD APT 206
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City | LA CROSSE
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State | WI
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Zip | 54601-3885
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Country | US
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Telephone | 320-385-0688
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number |
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License Number State |
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