Provider Demographics
NPI:1548548548
Name:COLBY, BRANDON ROSS (MD)
Entity type:Individual
Prefix:DR
First Name:BRANDON
Middle Name:ROSS
Last Name:COLBY
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:10780 SANTA MONICA BLVD
Mailing Address - Street 2:SUITE 360
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90025-4749
Mailing Address - Country:US
Mailing Address - Phone:424-245-5878
Mailing Address - Fax:424-288-4103
Practice Address - Street 1:10780 SANTA MONICA BLVD
Practice Address - Street 2:SUITE 360
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90025-4749
Practice Address - Country:US
Practice Address - Phone:424-245-5878
Practice Address - Fax:424-288-4103
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-26
Last Update Date:2011-07-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY255304207SG0201X
CAA92750207SG0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207SG0201XAllopathic & Osteopathic PhysiciansMedical GeneticsClinical Genetics (M.D.)