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NPI Code Detail

MEDICARE: BRANDON MAXWELL

MEDICARE: BRANDON MAXWELL
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine PhysicianPTL7279CA

General Provider Information

NPI Number : 1295304368
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRANDON MAXWELL
Provider Business Mailing Address
First Line : 1201 ALHAMBRA BLVD STE 340
Second Line :
City : SACRAMENTO
State : CA
Zip : 95816-5242
Country : US
Telephone Number : 916-451-4400
Fax Number :
Provider Business Practice Location Address
First Line : 2030 SUTTER PL STE 2000
Second Line :
City : DAVIS
State : CA
Zip : 95616-6216
Country : US
Telephone Number : 916-451-4400
Fax Number : 916-731-7955
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/22/2021
Last Update Date : 06/23/2023

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Directions to “ BRANDON MAXWELL ” Practice Location

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