Brandau, Kim M

Brandau, Kim M is an individual health care provider with primary practice located at 450 Williams Way , Moab UT 84532-2185. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / General Practice, Allopathic & Osteopathic Physicians / Colon & Rectal Surgery. Allopathic & Osteopathic Physicians / Colon & Rectal Surgery is her primary health care specialty. Brandau, Kim M can be contacted via phone (714) 772-6701.

Contact Information

Primary practice address
450 Williams Way Moab UT 84532-2185
Fax: (714) 772-5240
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / General Practice 208D00000X 9740645-1205 Utah
Allopathic & Osteopathic Physicians / Colon & Rectal Surgery 208C00000X 9740645-1205 Utah

Profile Details

NPI number 1871520742
LBN Legal business name Brandau, Kim M
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 27th, 2006
Last updated Sep 23rd, 2020 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1871520742 NPPES
California MEDICAID GR0000190

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