Organization
DAVID C. BRADSHAW, M.D. APC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID CLIETT BRADSHAW M.D. (OWNER/PHYSICIAN)
(510) 964-0458
Entity
Organization
Contact information
Practice address
19830 LAKE CHABOT RD, SUITE C, CASTRO VALLEY, CA 94546-4063
(510) 964-0458
(510) 964-0476
Mailing address
PO BOX 1460, SUISUN CITY, CA 94585-4460
(510) 964-0458
(510) 964-0476
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
C38599
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00C385990
—
CA
Enumeration date
03/17/2010
Last updated
03/17/2010
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