Provider Demographics
NPI:1518279900
Name:M. BRANDON FREEMAN, MD, PHD, PC
Entity Type:Organization
Organization Name:M. BRANDON FREEMAN, MD, PHD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:BRANDON
Authorized Official - Last Name:FREEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MBA, MD, PHD
Authorized Official - Phone:401-261-3813
Mailing Address - Street 1:1201 24TH ST
Mailing Address - Street 2:STE B110-270
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93301-2300
Mailing Address - Country:US
Mailing Address - Phone:661-808-4070
Mailing Address - Fax:
Practice Address - Street 1:2701 CHESTER AVE
Practice Address - Street 2:STE 103
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93301-2016
Practice Address - Country:US
Practice Address - Phone:661-808-4070
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-14
Last Update Date:2016-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA103459208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty