MEDICARE: MR. SCOTT A BRANDON CST,CSFA

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	246ZC0007X	Surgical Assistant	125635	NV

General Provider Information

NPI Number	:	1851687693
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. SCOTT A BRANDON CST,CSFA

Provider Business Mailing Address
First Line	:	1857 DERBYSHIRE DR
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-5358
Country	:	US
Telephone Number	:	702-445-4166
Fax Number	:

Provider Business Practice Location Address
First Line	:	1857 DERBYSHIRE DR
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-5358
Country	:	US
Telephone Number	:	702-445-4166
Fax Number	:

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

Provider Enumeration Date	:	06/20/2011
Last Update Date	:	06/20/2011

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Directions to “ MR. SCOTT A BRANDON CST,CSFA” Practice Location

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