MEDICARE: SIERRA NICOLE BRANDT-GRAY PHARMD

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
1	183500000X	Pharmacist	RPH91677	CA

General Provider Information

NPI Number	:	1710857743
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SIERRA NICOLE BRANDT-GRAY PHARMD

Provider Business Mailing Address
First Line	:	1026 SEA BREEZE DR
Second Line	:
City	:	COSTA MESA
State	:	CA
Zip	:	92627-3935
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	12110 HADLEY ST
Second Line	:
City	:	WHITTIER
State	:	CA
Zip	:	90601-3912
Country	:	US
Telephone Number	:	562-698-6305
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/05/2025
Last Update Date	:	11/05/2025

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Directions to “ SIERRA NICOLE BRANDT-GRAY PHARMD” Practice Location

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