Provider Demographics
NPI:1699925941
Name:RICHARD D. BRAND, M.D., A PROFESSIONAL CORPORATION
Entity type:Organization
Organization Name:RICHARD D. BRAND, M.D., A PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RICAHRD
Authorized Official - Middle Name:DANIEL
Authorized Official - Last Name:BRAND
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:805-983-0425
Mailing Address - Street 1:2241 WANKEL WAY STE B
Mailing Address - Street 2:
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93030-0191
Mailing Address - Country:US
Mailing Address - Phone:805-983-0425
Mailing Address - Fax:805-983-0414
Practice Address - Street 1:2241 WANKEL WAY STE B
Practice Address - Street 2:
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93030-0191
Practice Address - Country:US
Practice Address - Phone:805-983-0425
Practice Address - Fax:805-983-0414
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-23
Last Update Date:2018-10-12
Deactivation Date:2009-05-07
Deactivation Code:
Reactivation Date:2018-10-12
Provider Licenses
StateLicense IDTaxonomies
CAG30006207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty