Individual
BRADLEY CURTIS IDELSHON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1057 E GRAND AVE, ARROYO GRANDE, CA 93420-2504
(805) 270-1700
(805) 481-7097
Mailing address
2050 S BLOSSER RD, SANTA MARIA, CA 93458-7310
(805) 361-8028
(805) 361-8097
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
20A5884
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
FHC71031F
—
CA
05
—
FHC71032F
—
CA
01
—
HAP71031F
FAMILY PACK
CA
Enumeration date
04/25/2006
Last updated
06/11/2015
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