Individual
DR. BRADLEY G DOUGLAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARM.D.
Contact information
Practice address
101 DRUMMOND AVE, RIDGECREST, CA 93555-3117
(760) 384-2358
(760) 384-2493
Mailing address
833 E CHURCH AVE, RIDGECREST, CA 93555-4339
(760) 384-2358
(760) 384-2358
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
63177
CA
Other
Enumeration date
08/25/2011
Last updated
08/25/2011
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