Individual
PROF. LISA LAVERNE BRADLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3831 STOCKER ST, LOS ANGELES, CA 90008-5103
(323) 291-6234
(323) 291-7953
Mailing address
2823 E 7TH ST, APT. 8, LONG BEACH, CA 90804-4803
(562) 225-0450
(323) 291-7953
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
CA13997
CA
Other
Enumeration date
01/05/2007
Last updated
07/08/2007
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