Individual
JOHN SCOTT BRADLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3020 CHILDRENS WAY, SAN DIEGO, CA 92123-4223
(858) 966-7785
(858) 966-8658
Mailing address
3860 CALLE FORTUNADA, SUITE 210, SAN DIEGO, CA 92123-4800
(858) 309-6303
(858) 309-6301
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
G35234
CA
2080P0208X
Pediatric Infectious Diseases Physician
Primary
G35234
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G352340
—
CA
Enumeration date
11/13/2006
Last updated
11/03/2011
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