Active NPI
Tonda D Bradshaw D O a Professional Corporation
- Primary Care Clinic/Center
- Yucaipa, CA
National Provider Identifier
1871777664
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Primary Care Clinic/Center
- Legal business name
- TONDA D BRADSHAW D O A PROFESSIONAL CORPORATION
- Practice address
- 35237 Yucaipa Blvd
Yucaipa, CA 92399-4340 - Phone
- (909) 790-6200
- Fax
- (909) 790-6220
- NPI assigned
- Dec 28, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Tonda D Bradshaw, D.O.
- Title
- President
- Phone
- (909) 790-6200
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Primary Care Clinic/Center | 261QP2300X | Primary |
Addresses
Primary practice location
35237 Yucaipa Blvd
Yucaipa, CA 92399-4340
Mailing address
35237 Yucaipa Blvd
Yucaipa, CA 92399-4340
Phone (909) 790-6200
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
National Provider Directory
National Provider Directory- Tax ID family
- Tonda D Bradshaw D O a Professional Corporation
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Non-Pharmacy Dispensing Site
- Yucaipa, CA
- NPI 1972646784
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Internal Medicine Physician
- Yucaipa, CA
- NPI 1760574123
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1198800000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1550793600000",
"number": "1871777664",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "35237 YUCAIPA BLVD",
"city": "YUCAIPA",
"state": "CA",
"postal_code": "923994340",
"telephone_number": "909-790-6200",
"fax_number": "909-790-6220"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "35237 YUCAIPA BLVD",
"city": "YUCAIPA",
"state": "CA",
"postal_code": "923994340",
"telephone_number": "909-790-6200",
"fax_number": "909-790-6220"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "TONDA D BRADSHAW D O A PROFESSIONAL CORPORATION",
"organizational_subpart": "NO",
"enumeration_date": "2007-12-28",
"last_updated": "2019-02-22",
"status": "A",
"authorized_official_last_name": "BRADSHAW",
"authorized_official_first_name": "TONDA",
"authorized_official_middle_name": "D",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "909-790-6200",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "D.O."
},
"taxonomies": [
{
"code": "261QP2300X",
"taxonomy_group": "",
"desc": "Clinic/Center, Primary Care",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Yucaipa, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.