Brandon Tyler Fong

NPI #1578036687 in Antelope, California

Provider Information

NPI Number: 1578036687
Entity Type: Individual
Name: Brandon Tyler Fong
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Pharmacist
Enumeration Date: Jan 11, 2019
Last Updated: Jan 11, 2019

Practice Location

Address: 7901 WATT AVE
City: Antelope
State: California
ZIP Code: 95843-2002
Phone: (916) 747-2746

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pharmacist	183500000X	Primary

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