Individual
BRADLEY BERGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
630 BERCUT DR, SACRAMENTO, CA 95811-0110
(916) 441-3819
Mailing address
6725 ADMIRAL AVE, FAIR OAKS, CA 95628-3216
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
281807
CA
Other
Enumeration date
09/18/2019
Last updated
09/18/2019
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