# DR. BRADFORD H HACK

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1154312536
- **Gender:** Man
- **Credential:** M.D.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | G46616 | CA | Yes |

## Other

- **Enumeration date:** 11/03/2005
- **Last updated:** 01/10/2014

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1154312536 | — | CA |
| 01 | — | FC012Z | MEDICARE | CO |
| 01 | — | P00951196 | MEDICARE RAIL ROAD | CA |