Individual
BRADLEY CALLISTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
140 AVENIDA DEL MAR, SAN CLEMENTE, CA 92672-4016
(949) 492-1853
Mailing address
140 AVENIDA DEL MAR, SAN CLEMENTE, CA 92672-4016
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
33717TLG
CA
Other
Enumeration date
06/27/2017
Last updated
02/11/2019
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