Laura Bradley, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

53585 Issued in CA

Practice address

480 4TH Ave
Suite 307
Chula Vista, CA 91910-4410

Phone

(619) 426-3240

Fax

(619) 426-5964

NPI assigned

Jul 28, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Planned Parenthood of the Pacific Southwest

  • Community Health Clinic/Center
  • San Diego, CA
  • NPI 1427081652
  NPD (past)

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

{
    "created_epoch": "1469664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1469664000000",
    "number": "1902359607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "480 4TH AVE",
            "address_2": "SUITE 307",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919104403",
            "telephone_number": "619-426-3240",
            "fax_number": "619-426-5964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "480 4TH AVE",
            "address_2": "SUITE 307",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919104410",
            "telephone_number": "619-426-3240",
            "fax_number": "619-426-5964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADLEY",
        "first_name": "LAURA",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-07-28",
        "last_updated": "2016-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "53585",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CA",
            "license": "53585",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anne Elizabeth Bowman, D.D.S.
• Nymoni Bowman
• Franklin Miles Boyer, M.D.
• Jessica Marie Boyer, DACM
• Elion Brace, MD
• Sarah K Bradley
• Timothy Lewis Bradshaw, O.D.
• Nathalia Brambila
• Branch Medical Clinic Eastlake
• Hannah K Branch, LMFT

• Medical Physician Assistant in Chula Vista, CA
• Providers in Chula Vista, CA by specialty
• Medical Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2016; 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.