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General NPI Number Information
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NPI Number | 1619592581
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Entity Type | Individual
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Provider Name | BRANDON ROBERT MADURA DO
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Gender | Male
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Dates
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Enumeration Date | 06/16/2020
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Last Update Date | 08/22/2025
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Provider Practice Location Address
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Address Line | 70 N MCCLINTOCK DR STE 4
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City | CHANDLER
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State | AZ
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Zip | 85226-3711
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Country | US
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Telephone | 480-405-5384
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Fax |
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Provider Business Mailing Address
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Address Line | 3835 N FREEWAY BLVD STE 100
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City | SACRAMENTO
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State | CA
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Zip | 95834-1954
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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 | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number | 010268
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 010268
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License Number State | AZ
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