Provider Demographics
NPI:1083318810
Name:BRANDSTETTER, ROBIN (DO, MS)
Entity type:Individual
Prefix:
First Name:ROBIN
Middle Name:
Last Name:BRANDSTETTER
Suffix:
Gender:M
Credentials:DO, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1140 TUOLUMNE ST
Mailing Address - Street 2:
Mailing Address - City:VALLEJO
Mailing Address - State:CA
Mailing Address - Zip Code:94590-3920
Mailing Address - Country:US
Mailing Address - Phone:971-275-7011
Mailing Address - Fax:
Practice Address - Street 1:2480 SONOMA ST
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96001-3027
Practice Address - Country:US
Practice Address - Phone:530-225-7800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-27
Last Update Date:2023-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program