Provider Demographics
NPI:1659715381
Name:RICHLAND, BRANDON KIKUO (MD)
Entity Type:Individual
Prefix:
First Name:BRANDON
Middle Name:KIKUO
Last Name:RICHLAND
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9900 TALBERT AVE # 101
Mailing Address - Street 2:
Mailing Address - City:FOUNTAIN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92708-5153
Mailing Address - Country:US
Mailing Address - Phone:714-241-0646
Mailing Address - Fax:714-241-9029
Practice Address - Street 1:9900 TALBERT AVE # 101
Practice Address - Street 2:
Practice Address - City:FOUNTAIN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92708-5153
Practice Address - Country:US
Practice Address - Phone:714-241-0646
Practice Address - Fax:714-241-9029
Is Sole Proprietor?:No
Enumeration Date:2013-04-24
Last Update Date:2020-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA1323982086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery