Provider Demographics
NPI:1346988631
Name:BRANAN, KATHRYN (BS, PHARMD)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:
Last Name:BRANAN
Suffix:
Gender:F
Credentials:BS, PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2329 CAMINITO RECODO
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92107-1529
Mailing Address - Country:US
Mailing Address - Phone:858-472-7044
Mailing Address - Fax:
Practice Address - Street 1:7200 PARKWAY DR STE 104
Practice Address - Street 2:
Practice Address - City:LA MESA
Practice Address - State:CA
Practice Address - Zip Code:91942-1534
Practice Address - Country:US
Practice Address - Phone:619-303-3572
Practice Address - Fax:619-303-3623
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-25
Last Update Date:2022-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA58189183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist