Provider Demographics
NPI:1093463374
Name:LEON, BRANDON (PA)
Entity Type:Individual
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First Name:BRANDON
Middle Name:
Last Name:LEON
Suffix:
Gender:M
Credentials:PA
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Mailing Address - Street 1:7357 GENESTA AVE
Mailing Address - Street 2:
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91406-2605
Mailing Address - Country:US
Mailing Address - Phone:818-231-9619
Mailing Address - Fax:
Practice Address - Street 1:18350 ROSCOE BLVD STE 600
Practice Address - Street 2:
Practice Address - City:NORTHRIDGE
Practice Address - State:CA
Practice Address - Zip Code:91325-4187
Practice Address - Country:US
Practice Address - Phone:818-727-1515
Practice Address - Fax:818-727-7997
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-15
Last Update Date:2022-08-25
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant