Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | EL 1864 | CA |
NPI | 1033406350 |
---|---|
Provider Name | Dr. Brayton R Campbell |
First Address | Grand Terrace, CA 92313-8302 |
Second Address | Loma Linda, CA 92357-1000 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/07/2011 |
Last Update Date | 07/07/2011 |