Individual
DR. BRADLEY MACGREGOR THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
400 S SEPULVEDA BLVD, SUITE 200, MANHATTAN BEACH, CA 90266-6814
(310) 546-3461
(310) 546-6481
Mailing address
400 S SEPULVEDA BLVD, SUITE 200, MANHATTAN BEACH, CA 90266-6814
(310) 546-3461
(310) 546-6481
Taxonomy
Speciality
Code
Description
License number
State
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
A72166
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ZZZ02606Z
BLUE SHIELD ZZ NUMBER
CA
Enumeration date
08/24/2006
Last updated
08/29/2016
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