Provider Demographics
NPI:1932788544
Name:MAIJALA, BRANDON CHARLES (DPM)
Entity type:Individual
Prefix:
First Name:BRANDON
Middle Name:CHARLES
Last Name:MAIJALA
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3340 W BALL RD STE G
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92804-3729
Mailing Address - Country:US
Mailing Address - Phone:657-441-1484
Mailing Address - Fax:888-440-1680
Practice Address - Street 1:3340 W BALL RD STE G
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92804-3729
Practice Address - Country:US
Practice Address - Phone:657-441-1484
Practice Address - Fax:888-440-1680
Is Sole Proprietor?:No
Enumeration Date:2021-04-02
Last Update Date:2025-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE5986213ES0103X, 213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
No213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery