Individual
BRADLEY WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
11262 CAMPUS ST, LOMA LINDA, CA 92350-1727
(909) 558-1000
Mailing address
11262 CAMPUS ST, LOMA LINDA, CA 92350-1727
(909) 558-1000
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
95026798
CA
Other
Enumeration date
04/16/2022
Last updated
04/01/2024
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