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General NPI Number Information
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NPI Number | 1518690205
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Entity Type | Individual
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Provider Name | BRANDON AUGUST COLE
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Gender | Male
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Dates
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Enumeration Date | 07/08/2022
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Last Update Date | 07/03/2025
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Provider Practice Location Address
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Address Line | 765 3RD AVE STE 100
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City | CHULA VISTA
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State | CA
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Zip | 91910-5842
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Country | US
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Telephone | 888-683-3860
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Fax |
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Provider Business Mailing Address
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Address Line | 5555 GROSSMONT CENTER DR
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City | LA MESA
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State | CA
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Zip | 91942-3019
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Country | US
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Telephone | 949-230-4065
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 95021860
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License Number State | CA
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