Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0400X | Rehabilitation Chiropractor | 23728 | CA |
NPI | 1114170776 |
---|---|
Provider Name | Bradford L Alex |
First Address | Encino, CA 91436-2004 |
Second Address | Encino, CA 91436-2004 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/10/2008 |
Last Update Date | 28/10/2008 |