Bradley I. Hall, O.D., P.C.

Primary specialty

OptometristTaxonomy code 152W00000X

License

COR 1054 Issued in CA

Legal business name

BRADLEY I. HALL, O.D., P.C.

Practice address

1900 Santa Rosa Ave
Santa Rosa, CA 95407-7621

Phone

(707) 570-2418

Fax

(707) 578-2076

NPI assigned

Dec 20, 2006

Organization subpart

No

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

Authorized official

Name

Bradley Ingalls Hall, O.D.

Title

President

Phone

(707) 570-2418

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1166572800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1750445318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 SANTA ROSA AVE",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954077621",
            "telephone_number": "707-570-2418",
            "fax_number": "707-578-2076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 SANTA ROSA AVE",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954077621",
            "telephone_number": "707-570-2418",
            "fax_number": "707-578-2076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRADLEY I. HALL, O.D., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HALL",
        "authorized_official_first_name": "BRADLEY",
        "authorized_official_middle_name": "INGALLS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "707-570-2418",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "COR 1054",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jenna Grace Bozzetto
• Brabetz, Inc.
• Ethan Brabo
• Albert Bracamonte
• Braden Partners LP
• Greer Verson Bradley, O.T.
• Lesley Bradley
• Nancy Bradley, MFT,
• Kerry Katherine Brady, MS OTR/L
• Lena Bragg

• Optometrist in Santa Rosa, CA
• Providers in Santa Rosa, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.