Individual
DR. CLARENCE HENRY BRADDOCK III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
200 UCLA MEDICAL PLZ STE 420, LOS ANGELES, CA 90095-3075
(310) 206-6232
(310) 206-3551
Mailing address
5767 W CENTURY BLVD STE 400, LOS ANGELES, CA 90045-5631
(310) 206-5046
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
G55945
CA
Other
Enumeration date
01/02/2007
Last updated
01/07/2020
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