Shane, Bradley Russell

Shane, Bradley Russell is an individual health care provider with primary practice located at 1260 15Th St Ste 1024 , Santa Monica CA 90404-1145. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatric Nephrology, Allopathic & Osteopathic Physicians / Neurology. Allopathic & Osteopathic Physicians / Neurology is his primary health care specialty. Shane, Bradley Russell can be contacted via phone (424) 259-8570.

Contact Information

Primary practice address
1260 15Th St Ste 1024 Santa Monica CA 90404-1145
Phone: (424) 259-8570
Fax: (424) 259-6180
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatric Nephrology 2080P0210X A194680 California
Allopathic & Osteopathic Physicians / Neurology 2084N0400X A194680 California

Profile Details

NPI number 1932720562
LBN Legal business name Shane, Bradley Russell
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 5th, 2020
Last updated Jul 11th, 2024 - about last year

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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