Brad Edward Budde, PHYSICAL THERAPIST
Individual provider Active NPI Physical Medicine & Rehabilitation Physician · Capistrano Beach, CA
NPI 1003374505 · NPPES record last updated Oct 9, 2019
Key facts
- NPI
- 1003374505
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Medicine & Rehabilitation Physician 208100000X
- License
- PT20093 (CA)
- Practice address
- 34316 Via Fortuna
Capistrano Beach, CA 92624-1310 - Phone
- (949) 933-4515
- NPI assigned
- Mar 4, 2019
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT20093 | CA | MD | Physical Medicine & Rehabilitation Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| JM Physical Therapy Inc | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Medicine & Rehabilitation Physician | 208100000X | PT20093 | CA | Yes |
Addresses
Primary practice location
34316 Via Fortuna
Capistrano Beach, CA 92624-1310
Mailing address
34316 Via Fortuna
Capistrano Beach, CA 92624-1310
Phone (949) 933-4515
Other practice location 1
68 Willow Rd
Menlo Park, CA 94025-3653
Phone (866) 839-6979
Other providers in Capistrano Beach, CA
- Christopher Beddoe
- Jitendra R Bhatt
- Catherine Breton
- Christopher James Brown
- Patricia Saccomanno Brown
- Capistrano Beach Care Center, LLC
- Capo Beach Healthcare LLC
- Capo by the Sea
- Capo Coast Detox LLC
- Capo Coast Recovery LLC
All providers in Capistrano Beach, CA · Physical Medicine & Rehabilitation Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 9, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.