Bandera, Bradley Charles

Bandera, Bradley Charles is an individual health care provider with primary practice located at 2200 Santa Monica Blvd John Wayne Cancer Institute, Santa Monica CA 90404. He recently has 3 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Surgical Oncology, Allopathic & Osteopathic Physicians / Surgery. Allopathic & Osteopathic Physicians / Surgical Oncology is his primary health care specialty. Bandera, Bradley Charles can be contacted via phone (310) 449-5249.

Contact Information

Primary practice address
2200 Santa Monica Blvd John Wayne Cancer Institute Santa Monica CA 90404
Phone: (310) 449-5249
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X 61600 Georgia
Allopathic & Osteopathic Physicians / Surgical Oncology 2086X0206X A135798 California
Allopathic & Osteopathic Physicians / Surgery 208600000X 61600 Georgia

Profile Details

NPI number 1427205681
LBN Legal business name Bandera, Bradley Charles
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 19th, 2008
Last updated Nov 29th, 2018 - about 6 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 1427205681 NPPES
Kansas MEDICAID 201124040A
Kansas MEDICAID 1427205681
Kansas MEDICAID 200619660A

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