| Provider / Organization | NPI | Date Certified |
|---|---|---|
| BRANDON COLE MANIBOG | 1861161689 | 2024-06-09 |
Brandon Cole Manibog is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1861161689. Registration indicates Brandon Cole Manibog is a provider of access to adult/geriatric primary care providers services with a specialization in Physician Assistants & Advanced Practice Nursing Providers, Nurse Practitioner Access to Pediatric Primary Care Providers (Physician Assistants & Advanced Practice Nursing Providers, Nurse Practitioner) (Physician Assistants & Advanced Practice Nursing Providers, Nurse Practitioner) (Nurse Practitioner, ) (All Other Specialties & Provider Types, ) (Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers)
| Entity Type | Individual |
| Provider Name | Brandon Cole Manibog FNP-C |
| Practice Office Address | 26910 SIERRA HWY STE D8 NEWHALL, CA US |
| Practice Office Telephone | 6612103240 |
| Mailing Address | 28576 FOOTHILL WAY SANTA CLARITA, CA 913503290 US |
| Business Telephone | 9285149131 |
| Address | City / State | Phone / Fax |
|---|---|---|
| 41210 11th St W # 1447 | Palmdale, CA 935511447 | 6619477100 |
| Code | Practice | License No State |
|---|---|---|
| 363L00000X PRIMARY | Access to Adult/Geriatric Primary Care Providers Physician Assistants & Advanced Practice Nursing Providers Nurse PractitionerAccess to Pediatric Primary Care Providers Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner Nurse Practitioner All Other Specialties & Provider Types Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers | 95018275
CA |