Bradley A Cole, M.D. – Neurology Physician

Key facts

NPI: 1669402558
Entity type: Individual (NPI type 1)
Primary specialty: Neurology Physician 2084N0400X
License: G78300 (CA)
Practice address: 7000 Boulder Ave
Highland, CA 92346-3348
Phone: (909) 862-1191
Fax: (909) 796-4158
NPI assigned: Jul 4, 2006
Sex: Male
Sole proprietor: No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Faculty Physicians and Surgeons of Llusm Family Medicine Physician · Moreno Valley, CA · NPI 1558788331

NPD (past)

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): Yes
Credentials: Doctor of Medicine

State licenses

License	State	Type	Specialty
G78300	CA	MD	Neurology Physician
G12287	CA	MD	Diagnostic Radiology Physician

Practice roles

Organization	Specialty	Status	New patients
Faculty Physicians and Surgeons of Llusm		Past	Accepting new patients

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Neurology Physician	2084N0400X	G78300	CA	Yes

Addresses

Primary practice location

7000 Boulder Ave
Highland, CA 92346-3348

Mailing address

PO Box 2200
Redlands, CA 92373-0722
Phone (909) 793-3311

Other identifiers

Identifier	Type	State	Issuer
00G783000	Medicaid	CA

Other providers in Highland, CA

All providers in Highland, CA · Neurology 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 Jul 8, 2007. 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.

Verify at the official NPI Registry.