Provider Demographics
NPI:1336193432
Name:BRANDTMAN, TODD E (MD)
Entity Type:Individual
Prefix:
First Name:TODD
Middle Name:E
Last Name:BRANDTMAN
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:PO BOX 5849
Mailing Address - Street 2:
Mailing Address - City:OROVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95966-0849
Mailing Address - Country:US
Mailing Address - Phone:530-228-5089
Mailing Address - Fax:
Practice Address - Street 1:1390 E LASSEN AVE
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95973-7823
Practice Address - Country:US
Practice Address - Phone:530-332-5540
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-22
Last Update Date:2021-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG42020207QH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QH0002XAllopathic & Osteopathic PhysiciansFamily MedicineHospice and Palliative Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA48777Medicare UPIN
CA00G420201Medicare PIN