Provider Demographics
NPI:1114652054
Name:GALINDO, BRANDON ANTHONY
Entity Type:Individual
Prefix:
First Name:BRANDON
Middle Name:ANTHONY
Last Name:GALINDO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2834 E HEMPSTEAD RD
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92806-3838
Mailing Address - Country:US
Mailing Address - Phone:714-350-1150
Mailing Address - Fax:
Practice Address - Street 1:2834 E HEMPSTEAD RD
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92806-3838
Practice Address - Country:US
Practice Address - Phone:714-350-1150
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-22
Last Update Date:2022-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA83641225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist