Doctor Name: | DR. DOUGLAS D BRADLEY |
NPI Number: | 1306829114 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | C27429 |
Business Practice Address: | 150 Muir Rd Martinez, CA - 945534668 |
Business Phone Number: | 9253722736 |
Business Fax Number: | |
Mailing Address: | Po Box 784, DIABLO |
State: | CA |
Postal Code: | 945280784 |
Phone Number: | 9258378716 |
Fax Number: | 9257431011 |
NPI Enumeration Date: | 11/25/2005 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | C27429 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |