Individual
ELISE NICOLE BRADLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MMS, PA-C
Contact information
Practice address
6195 LUSK BLVD STE 250, SAN DIEGO, CA 92121-3715
(858) 859-1188
Mailing address
6195 LUSK BLVD STE 250, SAN DIEGO, CA 92121-3715
(858) 859-1188
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
10/02/2018
Last updated
09/21/2025
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