Provider Demographics
NPI:1487744215
Name:ARAKAKI, BRANDON M
Entity type:Individual
Prefix:
First Name:BRANDON
Middle Name:M
Last Name:ARAKAKI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18377 BEACH BLVD
Mailing Address - Street 2:STE 216
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92648-1381
Mailing Address - Country:US
Mailing Address - Phone:714-848-8318
Mailing Address - Fax:714-848-8306
Practice Address - Street 1:18377 BEACH BLVD
Practice Address - Street 2:STE 216
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92648-1381
Practice Address - Country:US
Practice Address - Phone:714-848-8318
Practice Address - Fax:714-848-8306
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2021-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA27703225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA27703OtherPT LICENSE