Bradley Charles Bandera
Surgeon Surgical Oncologist
2200 Santa Monica Blvd John Wayne Cancer Institute
Santa Monica
, California 90404
Bradley Charles Bandera
Surgeon Surgical Oncologist
2200 Santa Monica Blvd John Wayne Cancer Institute
Santa Monica
, California 90404
(310) 449-5249
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About
Features
Specialties
- Surgeon
- Surgical Oncologist
Languages spoken
- English
Location
First Address
- Bradley Charles Bandera
- 2200 Santa Monica Blvd John Wayne Cancer Institute
- Santa Monica, CA
- Zip : 90404
- Phone : (310) 449-5249
Second Address
- Bradley Charles Bandera
- 2200 Santa Monica Blvd John Wayne Cancer Institute
- Santa Monica, CA
- Zip : 90404
- Phone : (310) 449-5249
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 208200000X | Surgeon | 61600 | GA |
| N | 208600000X | Surgeon | 61600 | GA |
| Y | 2086X0206X | Surgical Oncologist | A135798 | CA |
National Provider Identifier
| NPI | 1427205681 |
|---|---|
| Provider Name | Bradley Charles Bandera |
| First Address | Santa Monica, CA 90404 |
| Second Address | Santa Monica, CA 90404 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 19/08/2008 |
| Last Update Date | 29/11/2018 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 1427205681 | (05) | MO |
| 200619660A | (05) | OK |
| 201124040A | (05) | KS |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.