Individual
MR. BRADLEY JAMES YOUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
4760 W SUNSET BLVD, LOS ANGELES, CA 90027-6063
(323) 783-4878
Mailing address
4760 W SUNSET BLVD, LOS ANGELES, CA 90027-6063
(800) 954-8000
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA 14403
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1035657
NCCPA CERTIFICATE #
CA
01
—
PA 14403
PAEC LICENSE NUMBER
CA
Enumeration date
02/12/2007
Last updated
03/07/2023
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