Individual
MR. BRAD ROELOFS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CCT
Contact information
Practice address
27702 CROWN VALLEY PKWY, D4149, LADERA RANCH, CA 92694-0608
(949) 407-8911
Mailing address
27702 CROWN VALLEY PKWY # D4-149, LADERA RANCH, CA 92694-0608
Taxonomy
Speciality
Code
Description
License number
State
246W00000X
Cardiology Technician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ZZZ42363Z
BLUE SHIELD ITS
CA
Enumeration date
04/18/2008
Last updated
07/21/2016
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