Individual
DR. BRADFORD H HACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
301 W HUNTINGTON DR, SUITE 408, ARCADIA, CA 91007-3462
(626) 821-0707
(626) 821-0239
Mailing address
PO BOX 90730, PASADENA, CA 91109-0730
(626) 821-0707
(626) 821-0239
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
G46616
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1154312536
—
CA
01
—
FC012Z
MEDICARE
CO
01
—
P00951196
MEDICARE RAIL ROAD
CA
Enumeration date
11/03/2005
Last updated
01/10/2014
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