Individual
DR. BRADLEY GLENN JANN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.P.M
Contact information
Practice address
100 THORNDALE DR, MEDICAL CLINIC, SAN RAFAEL, CA 94903-4501
(415) 461-5995
(415) 461-5995
Mailing address
PO BOX 751347, PETALUMA, CA 94975-1347
(415) 461-5995
(707) 545-1783
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
E3865
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000E38650
—
CA
Enumeration date
10/04/2005
Last updated
07/25/2016
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