Bradley, Tyson John
Bradley, Tyson John is an individual health care provider with primary practice located at 34800 Bob Wilson Dr , San Diego CA 92134-1098. He recently has only one registered license in Other Service Providers / Independent Duty Corpsman, which is considered as his primary health care specialty. Bradley, Tyson John can be contacted via phone (619) 532-6400.Contact Information
Primary practice address
34800 Bob Wilson Dr
San Diego CA 92134-1098
Phone: (619) 532-6400
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Independent Duty Corpsman | 1710I1002X |
Profile Details
| NPI number | 1588122006 |
|---|---|
| LBN Legal business name | Bradley, Tyson John |
| Credentials | IDC |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 4th, 2019 |
| Last updated | Mar 4th, 2019 - about 5 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 | 1588122006 | NPPES |
| Florida | Other | B634-810-91-258-0 | TRICARE |
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