Bradley, Stephen Peter

Bradley, Stephen Peter is an sole proprietor health care provider with primary practice located at 5375 Lakeshore Blvd , Lakeport CA 95453-6123. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Surgery, Allopathic & Osteopathic Physicians / General Practice, Allopathic & Osteopathic Physicians / Addiction Medicine. Allopathic & Osteopathic Physicians / Addiction Medicine is his primary health care specialty. Bradley, Stephen Peter can be contacted via phone (707) 263-5679.

Contact Information

Primary practice address
5375 Lakeshore Blvd Lakeport CA 95453-6123
Phone: (707) 263-5679
Fax: (707) 263-7781
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X C41489 California
Allopathic & Osteopathic Physicians / General Practice 208D00000X C41489 California
Allopathic & Osteopathic Physicians / Addiction Medicine 207QA0401X C41489 California

Profile Details

NPI number 1699746446
LBN Legal business name Bradley, Stephen Peter
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 30th, 2006
Last updated Sep 12th, 2022 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1699746446 NPPES
California MEDICAID 00C414890

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