Basic Information
| Provider Information | |||||||||
| NPI: | 1407413412 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LUNG | ||||||||
| FirstName: | BRANDON | ||||||||
| MiddleName: | EVAN | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 101 THE CITY DRIVE SOUTH | ||||||||
| Address2: | DEPT OF ORTHO SURGERY, PAV III, 2ND FL, RTE 81 | ||||||||
| City: | ORANGE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 92868 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9498244405 | ||||||||
| FaxNumber: | 7144567547 | ||||||||
| Practice Location | |||||||||
| Address1: | 101 THE CITY DRIVE SOUTH | ||||||||
| Address2: | DEPT OF ORTHO SURGERY, PAV III, 2ND FL, RTE 81 | ||||||||
| City: | ORANGE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 92868 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9498244405 | ||||||||
| FaxNumber: | 7144567547 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/24/2019 | ||||||||
| LastUpdateDate: | 05/24/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | Y | Student, Health Care | Student in an Organized Health Care Education/Training Program |
No ID Information.