Individual
BRADLEY JONATHAN THOMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
10121 PINE AVE, TRUCKEE, CA 96161-4835
(530) 587-6011
Mailing address
PO BOX 34120, RENO, NV 89533-4120
(775) 747-5050
(775) 747-5005
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
G58233
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G582331
—
CA
Enumeration date
05/11/2006
Last updated
09/16/2009
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