Basic Information
| Provider Information | |||||||||
| NPI: | 1053523381 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | BRANDON VILLARREAL MD INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 25470 MEDICAL CENTER DRIVE | ||||||||
| Address2: | SUITE 206 | ||||||||
| City: | MURRIETA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 92562 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9519737380 | ||||||||
| FaxNumber: | 9519737389 | ||||||||
| Practice Location | |||||||||
| Address1: | 25500 MEDICAL CENTER DRIVE | ||||||||
| Address2: | |||||||||
| City: | MURRIETA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 92562 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9516966000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/07/2007 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | VILLARREAL | ||||||||
| AuthorizedOfficialFirstName: | BRANDON | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 9519737380 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | G60466 | CA | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Anesthesiology |
No ID Information.