Prestidge, Bradley Robert

Prestidge, Bradley Robert is an individual health care provider with primary practice located at 5930 Cornerstone Ct W , San Diego CA 92121-3741. He recently has only one registered license in Allopathic & Osteopathic Physicians / Radiation Oncology, which is considered as his primary health care specialty. Prestidge, Bradley Robert can be contacted via phone (619) 502-9084.

Contact Information

Primary practice address
5930 Cornerstone Ct W San Diego CA 92121-3741
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Radiation Oncology 2085R0001X 70262 Minnesota
Allopathic & Osteopathic Physicians / Radiation Oncology 2085R0001X H8803 Texas

Profile Details

NPI number 1134126220
LBN Legal business name Prestidge, Bradley Robert
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 5th, 2005
Last updated Sep 28th, 2021 - 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1134126220 NPPES
Virginia MEDICAID 1134126220

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