Individual
BRADLEY ANTHONY FIORELLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
301 VICTORIA ST, COSTA MESA, CA 92627-1995
(949) 642-2734
Mailing address
301 VICTORIA ST, COSTA MESA, CA 92627-1995
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
95388757
CA
Other
Enumeration date
08/22/2024
Last updated
08/22/2024
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