Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213E00000X | Podiatrist | E3423 | CA |
N | 222Z00000X | Podiatrist | E3423 | CA |
Y | 213ES0131X | Foot Surgery | E3423 | CA |
NPI | 1083706253 |
---|---|
Provider Name | Brad Naylor |
First Address | Los Altos, CA 94022-1408 |
Second Address | San Carlos, CA 94070-2603 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/09/2006 |
Last Update Date | 18/02/2020 |