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General NPI Number Information
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NPI Number | 1427753094
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Entity Type | Individual
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Provider Name | PATRICK BRANDAO
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Gender | Male
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Dates
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Enumeration Date | 04/03/2023
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Last Update Date | 09/05/2023
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Provider Practice Location Address
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Address Line | 1249 S LA BREA AVE
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City | LOS ANGELES
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State | CA
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Zip | 90019-1627
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Country | US
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Telephone | 323-708-7500
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Fax |
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Provider Business Mailing Address
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Address Line | 1229 N FLORES ST APT 6
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City | WEST HOLLYWOOD
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State | CA
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Zip | 90069-2988
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Country | US
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Telephone | 617-602-5489
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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