| Doctor Name: | MR. BRADLEY DEAN SUMMERS |
| NPI Number: | 1093864829 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PA |
| License Number: | PA17047 |
| Business Practice Address: | 1111 N China Lake Blvd Ridgecrest Regional Hospital Ridgecrest, CA - 935553131 |
| Business Phone Number: | 7604993800 |
| Business Fax Number: | |
| Mailing Address: | 4316 Marina City Dr, #419 MARINA DEL REY |
| State: | CA |
| Postal Code: | 902925832 |
| Phone Number: | 9092663988 |
| Fax Number: | |
| NPI Enumeration Date: | 01/10/2007 |
| NPI Last Update Date: | 10/18/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | PA17047 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |