Provider Demographics
NPI:1144566886
Name:LOMBARDO, BRANDAN (PHARMD)
Entity type:Individual
Prefix:
First Name:BRANDAN
Middle Name:
Last Name:LOMBARDO
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20315 VIA SANSOVINO
Mailing Address - Street 2:
Mailing Address - City:PORTER RANCH
Mailing Address - State:CA
Mailing Address - Zip Code:91326-4410
Mailing Address - Country:US
Mailing Address - Phone:818-772-9877
Mailing Address - Fax:
Practice Address - Street 1:20315 VIA SANSOVINO
Practice Address - Street 2:
Practice Address - City:PORTER RANCH
Practice Address - State:CA
Practice Address - Zip Code:91326-4410
Practice Address - Country:US
Practice Address - Phone:818-772-9877
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-12-28
Last Update Date:2012-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA67230183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist