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:
Health care specialties
| Specialty | Code | License # | 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 3 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1699746446 | NPPES |
| California | MEDICAID | 00C414890 |
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