Organization
BRADLEY I. HALL, O.D., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRADLEY INGALLS HALL O.D. (PRESIDENT)
(707) 570-2418
Entity
Organization
Contact information
Practice address
1900 SANTA ROSA AVE, SANTA ROSA, CA 95407-7621
(707) 570-2418
(707) 578-2076
Mailing address
1900 SANTA ROSA AVE, SANTA ROSA, CA 95407-7621
(707) 570-2418
(707) 578-2076
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
COR 1054
CA
Other
Enumeration date
12/20/2006
Last updated
08/22/2020
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