Individual
BRAD THOMAS MITSDARFFER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1401 S GRAND AVE, LOS ANGELES, CA 90015-3010
(213) 748-2411
Mailing address
1540 FAIRFIELD CT, LEWISVILLE, TX 75077-3722
(214) 223-3750
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
114912-23
NH
367500000X
Certified Registered Nurse Anesthetist
Primary
AP130007
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
357507801
—
TX
Enumeration date
03/31/2016
Last updated
06/23/2025
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