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BENJAMIN BRADLEY PA-C

>> Physician Assistant >> Physician Assistants & Advanced Practice Nursing Providers

Registrant NPI Number: 1548546435

Individual Registrant:
 BENJAMIN  BRADLEY PA-C
Gender: M
Not Sole Proprietor

Location and contact information for practice:
12586 AVENUE 408  CUTLER/OROSI, CA 93647-9454 US
Tel: 559-528-2804  Fax: 559-528-7623

Contact information for business:
305 EAST CENTER AVE.  VISALIA, CA 93291-6331 US
Tel: 559-737-4700  Fax: 559-737-4782

Registration Information:
NPI: 1548546435
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
N363A00000XPhysician Assistants & Advanced Practice Nursing Providers
Physician Assistant
CAPA21965
Y363A00000XPhysician Assistants & Advanced Practice Nursing Providers
Physician Assistant
CA

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
LICENSEPA21965CA01




HEALTH CARE JOBS CA - Page 1



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