Active NPI
Bradley Randall Bennett, PHARMD
- Pharmacist
- Walnut Creek, CA
National Provider Identifier
1245398528
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 51099
- Practice address
- 1425 S Main St
Walnut Creek, CA 94596-5318 - Phone
- (925) 295-6301
- Fax
- (925) 295-6290
- NPI assigned
- Dec 5, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 51099 | CA | Primary |
Addresses
Primary practice location
1425 S Main St
Walnut Creek, CA 94596-5318
Mailing address
3173 Lucas Dr
Lafayette, CA 94549-5561
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 51099 | CA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165276800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1245398528",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3173 LUCAS DR",
"city": "LAFAYETTE",
"state": "CA",
"postal_code": "945495561"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1425 S MAIN ST",
"city": "WALNUT CREEK",
"state": "CA",
"postal_code": "945965318",
"telephone_number": "925-295-6301",
"fax_number": "925-295-6290"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BENNETT",
"first_name": "BRADLEY",
"middle_name": "RANDALL",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-05",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "51099",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Walnut Creek, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.