Bradly James Stilley, IDC

Primary specialty

Independent Duty CorpsmanTaxonomy code 1710I1002X

Practice address

34800 Bob Wilson Dr
San Diego, CA 92134-1098

Phone

(360) 941-9989

NPI assigned

Sep 28, 2017

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1506556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1506556800000",
    "number": "1003325499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10156 ORLECK ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921242509",
            "telephone_number": "360-941-9989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34800 BOB WILSON DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921341098",
            "telephone_number": "360-941-9989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STILLEY",
        "first_name": "BRADLY",
        "middle_name": "JAMES",
        "credential": "IDC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-09-28",
        "last_updated": "2017-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1710I1002X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Military Health Care Provider, Independent Duty Corpsman",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carren Jean Stika, PH.D.
• Bradford Hugh Stiles, M.D.
• Geoffrey M Stiles, MD
• Jaqueline Stiles, RN
• Still Waters Aquamation & Transport, Inc
• Jayne Victoria Stillings, M.D.
• Kristina Coale Stillwell, M.D.
• Michael Christopher Stiltz, RADT-1
• Robert Stimart
• Elizabeth O Stimson, NP

• Independent Duty Corpsman in San Diego, CA
• Providers in San Diego, CA by specialty
• Independent Duty Corpsman in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.