Brad a Wolfson M D a Medical Corporation

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

G61080 Issued in CA

Legal business name

BRAD A WOLFSON M D A MEDICAL CORPORATION

Practice address

555 E Tachevah Dr Ste 2
Palm Springs, CA 92262-5750

Phone

(760) 320-6005

Fax

(760) 323-5786

NPI assigned

Oct 6, 2009

Last updated

Feb 25, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Doris Olivia Eberhardt, CPC, CUC

Title

Office Manager

Phone

(760) 320-6005

Specialties & licenses 1

Addresses

Other identifiers 2

Electronic endpoints 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Madhumitha C Reddy, D.O

  • Urology Physician
  • Murrieta, CA
  • NPI 1568724417
  NPD
• Brian Wesley Willis, AGPCNP-BC

  • Primary Care Nurse Practitioner
  • Palm Springs, CA
  • NPI 1841007127
  NPD

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

{
    "created_epoch": "1254787200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1645747200000",
    "number": "1912232166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 E TACHEVAH DR",
            "address_2": "SUITE 2 WEST 101",
            "city": "PALM SPRINGS",
            "state": "CA",
            "postal_code": "922625750",
            "telephone_number": "760-320-6005",
            "fax_number": "760-323-5786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 E TACHEVAH DR STE 2",
            "city": "PALM SPRINGS",
            "state": "CA",
            "postal_code": "922625750",
            "telephone_number": "760-320-6005",
            "fax_number": "760-323-5786"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRAD A WOLFSON M D A MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-06",
        "last_updated": "2022-02-25",
        "certification_date": "2022-02-25",
        "status": "A",
        "authorized_official_last_name": "EBERHARDT",
        "authorized_official_first_name": "DORIS",
        "authorized_official_middle_name": "OLIVIA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "760-320-6005",
        "authorized_official_credential": "CPC, CUC"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Urology",
            "state": "CA",
            "license": "G61080",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CA MEDICAL LICENSE",
            "identifier": "G61080",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G610801",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "doris.eberhardt@outlook.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "555 E Tachevah Dr Ste 2",
            "city": "Palm Springs",
            "state": "CA",
            "country_code": "US",
            "postal_code": "922625750",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Dorene Kristine Bowling
• Paul Duncan Boyd, FNP
• Michael Boyer
• Kyle Rockne Boylan, FNP-BC
• BQ Enterprises Inc. (Home Health Angels)
• Braden Partners LP (Pacific Pulmonary Services)
• David Bradford
• Shawnee Bradley, FNP-BC
• Chad Braun, M.D.
• Thomas Brazeal

• Urology Physician in Palm Springs, CA
• Providers in Palm Springs, CA by specialty
• Urology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2022; 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.