Brandon J Cornejo MD, PH.D.

NPI 1053576082 - General Practice - 208D00000X

NPI Details
NPI 1053576082
Gender Male
Enumeration Date 07/18/2008
Last Updated 07/12/2012
Entity Type Individual
Active Over 8 years ago
Practice Location
3550 NORTH INTERSTATE AVE.
KAISER PERMANENTE - INTERSTATE MEDICAL OFFICE EAST
PORTLAND OR, 97227-1106, US
Phone (503) 285-9321
Fax
Business Location
3550 NORTH INTERSTATE AVE.
KAISER PERMANENTE INTERSTATE OFFICE EAST
PORTLAND OR, 97227-1106, US
Phone (503) 285-9321
Fax
Toxanomy
Taxonomy Code 208D00000X
License State Wisconsin
License Number 54982-020
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According to our database, Brandon J Cornejo MD, PH.D. NPI is 1053576082, taxonomy code is 208D00000X and license number is 54982-020, license state is located at Wisconsin. Brandon J Cornejo MD, PH.D. physically located at 3550 North Interstate Ave., Portland OR, 97227-1106. NPI Number Brandon J Cornejo MD, PH.D. has the Individual type.

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1053576082 NPI number is provided on an as is basis without warranty of any kind. 1053576082 is maintained by the National Plan & Provider Enumeration System. The contents of Brandon J Cornejo MD, PH.D. are for informational purposes only.