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General NPI Number Information
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NPI Number | 1750363966
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Entity Type | Individual
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Provider Name | JUDITH BRANDT DO, FAAFP
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Gender | Female
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Dates
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Enumeration Date | 11/15/2005
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Last Update Date | 10/28/2022
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Provider Practice Location Address
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Address Line | 3070 CAMINO HEIGHTS DR STE B
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City | CAMINO
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State | CA
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Zip | 95709-9508
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Country | US
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Telephone | 530-651-2000
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Fax | 530-647-1961
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Provider Business Mailing Address
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Address Line | 3070 CAMINO HEIGHTS DR SUITE B
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City | CAMINO
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State | CA
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Zip | 95709-9508
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Country | US
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Telephone | 530-647-9762
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Fax | 530-647-1961
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 20A6245
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License Number State | CA
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