Individual
BRADLEY C POWERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
801 S CHEVY CHASE DR STE 105, GLENDALE, CA 91205-4432
(818) 265-2200
(818) 265-2201
Mailing address
8237 RAVENDALE RD, SAN GABRIEL, CA 91775-1041
(626) 292-7563
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
A63910
CA
207Q00000X
Family Medicine Physician
Primary
A63910
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7953469
AETNA
CA
01
—
A63910
LICENSE
CA
Enumeration date
07/19/2006
Last updated
03/07/2023
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