Deal, Bradley Kenneth

Deal, Bradley Kenneth is an individual health care provider with primary practice located at 13 Main St. San Quentin Prison, San Quentin CA 94964. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Psychiatry, Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry. Allopathic & Osteopathic Physicians / Psychiatry is his primary health care specialty. Deal, Bradley Kenneth can be contacted via phone (415) 454-1460.

Contact Information

Primary practice address
13 Main St. San Quentin Prison San Quentin CA 94964
Phone: (415) 454-1460
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X ME94046 Florida
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X A102530 California
Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry 2084P0804X ME94046 Florida
Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry 2084P0804X A102530 California

Profile Details

NPI number 1518958743
LBN Legal business name Deal, Bradley Kenneth
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 5th, 2005
Last updated Mar 15th, 2012 - about 14 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 1518958743 NPPES
Florida MEDICAID 276684100

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